Palsbo Susan E, Ho Pei-Shu
Center for the Study of Chronic Illness and Disability, College of Health and Human Services, George Mason University, VA, USA.
J Health Care Poor Underserved. 2007 Nov;18(4):887-901. doi: 10.1353/hpu.2007.0104.
Disability care coordination organizations (DCCOs) arrange comprehensive, disability-competent social and medical services for people with disabilities. This study used consumer ratings of access and quality to measure outcomes in one of the first operational DCCOs over a three-year period. Working-age Medicaid adults with physical disabilities reported statistically significant improvements in service coordination, patient education, system-wide disability competency, comprehensive assessment, health visit support, and self-direction of care. Global quality ratings showed statistically significant and sustained improvement over two years, with the percentage of people rating the health system as excellent rising from 7% before enrollment to 44% in the DCCO. The percentage of people rating primary care physicians as excellent rose from 18% before enrollment to 38% in the DCCO. Over time, enrollees became more knowledgeable about the need for preventive health care services, were more likely to receive needed care and medical equipment, and reduced their need for rehabilitation therapies. Disability care coordination organizations can reduce disparities and improve access to care for this vulnerable population.
残疾护理协调组织(DCCOs)为残疾人安排全面且具备残疾护理能力的社会和医疗服务。本研究使用消费者对服务可及性和质量的评分,来衡量首个投入运营的DCCOs之一在三年期间的成果。有身体残疾的劳动年龄医疗补助计划成年人报告称,在服务协调、患者教育、全系统残疾护理能力、综合评估、健康访视支持和自我护理指导方面有统计学上的显著改善。整体质量评分显示,在两年内有统计学上的显著且持续的改善,将医疗系统评为优秀的人群比例从入组前的7%升至DCCO中的44%。将初级保健医生评为优秀的人群比例从入组前的18%升至DCCO中的38%。随着时间推移,参保者对预防性医疗保健服务需求的了解增多,更有可能获得所需护理和医疗设备,并减少了对康复治疗的需求。残疾护理协调组织可以减少差异,改善这一弱势群体获得护理的机会。