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两个州向儿科综合医疗模式过渡期间儿童服务的使用情况。

Children's service use during the transition to PCCM in two states.

作者信息

Bronstein Janet M, Adams E Kathleen, Florence Curtis S

机构信息

University of Alabama at Birmingham, School of Public Health, 35294-0022, USA.

出版信息

Health Care Financ Rev. 2005 Summer;26(4):95-108.

PMID:17288071
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4194912/
Abstract

This study examines whether use of primary, preventive, or emergency care changed as primary care case management (PCCM) programs for children were implemented in Alabama and Georgia. Using claims data we track the same children over time, and control for geographic availability of Medicaid providers, which also changed over this period. A decline in use of all three types of care was found to be associated with PCCM implementation, with use of primary and preventive care falling below national averages and recommended use rates. Family difficulties in shifting to exclusive use of unfamiliar providers is the primary reason for the decline in use rates.

摘要

本研究考察了在阿拉巴马州和佐治亚州实施针对儿童的初级保健病例管理（PCCM）项目时，初级、预防或急诊护理的使用情况是否发生了变化。我们利用索赔数据对同一批儿童进行长期跟踪，并控制医疗补助提供者的地理可及性，在此期间这一因素也发生了变化。研究发现，这三种护理的使用量下降均与PCCM项目的实施有关，初级和预防护理的使用量低于全国平均水平及推荐使用率。家庭在转向专门使用不熟悉的提供者时遇到困难是使用率下降的主要原因。

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The impact of Medicaid primary care case management on office-based physician supply in Alabama and Georgia.医疗补助初级保健病例管理对阿拉巴马州和佐治亚州门诊医生供给的影响。
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2
Usual source of care in preventive service use: a regular doctor versus a regular site.预防性服务使用中的常规护理来源：普通医生与常规场所。
Health Serv Res. 2002 Dec;37(6):1509-29. doi: 10.1111/1475-6773.10524.
3
Has Medicaid managed care affected beneficiary access and use?医疗补助管理式医疗是否影响了受益人的就医机会和医疗服务利用情况？
Inquiry. 2002 Fall;39(3):221-42. doi: 10.5034/inquiryjrnl_39.3.221.
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Health care for children and youth in the United States: 2001 annual report on access, utilization, quality, and expenditures.美国儿童和青少年的医疗保健：2001年关于可及性、利用情况、质量和支出的年度报告。
Ambul Pediatr. 2002 Nov-Dec;2(6):419-37. doi: 10.1367/1539-4409(2002)002<0419:hcfcay>2.0.co;2.
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Impacts of Medicaid managed care on children.医疗补助管理式医疗对儿童的影响。
Health Serv Res. 2001 Apr;36(1 Pt 1):7-23.
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"Narrowing the Gap": decreasing emergency department use by children enrolled in the Medicaid program by improving access to primary care.“缩小差距”：通过改善初级医疗服务的可及性，减少参加医疗补助计划儿童的急诊科就诊率。
Arch Pediatr Adolesc Med. 2000 Aug;154(8):791-5. doi: 10.1001/archpedi.154.8.791.
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