向管理式医疗的转变影响了医疗补助计划参保儿童的医疗服务利用情况。

Transition to managed care impacts health care service utilization by children insured by Medicaid.

作者信息

Bollinger Mary Elizabeth, Smith Sheila Weiss, LoCasale Robert, Blaisdell Carol

机构信息

University of Maryland School of Medicine, Department of Pediatrics, Division of Pediatric Pulmonology/Allergy, Baltimore, Maryland 21201, USA.

出版信息

J Asthma. 2007 Nov;44(9):717-22. doi: 10.1080/02770900701595584.

DOI:10.1080/02770900701595584

PMID:17994400

Abstract

Purpose. To evaluate the impact of transition to managed care from fee for service on asthma service utilization among Maryland Medicaid insured children. Methods. Healthcare claims from 1997-2000 for children with asthma insured by Maryland Medicaid were extracted and analyzed. Results. Between 1997-2000, inhaled corticosteroid use increased as a proportion of all asthma medications. Outpatient asthma visits increased from 4.2% to 5.9% of all outpatient claims as both asthma-related hospitalizations and emergency department visits decreased. Conclusions. Restructuring of Maryland Medicaid for children from fee for service to managed care was associated with improvement in asthma-related healthcare utilization claims.

摘要

目的。评估从按服务收费过渡到管理式医疗对马里兰州医疗补助参保儿童哮喘服务利用情况的影响。方法。提取并分析了1997年至2000年马里兰州医疗补助所承保的哮喘儿童的医疗理赔数据。结果。在1997年至2000年期间，吸入性糖皮质激素的使用量在所有哮喘药物中所占比例有所增加。随着与哮喘相关的住院治疗和急诊就诊次数减少，哮喘门诊就诊次数从所有门诊理赔的4.2%增加到5.9%。结论。马里兰州针对儿童的医疗补助从按服务收费改组为管理式医疗，与哮喘相关医疗利用理赔情况的改善有关。