残疾劳动年龄成年人中个人协助服务利用与其他医疗补助支付之间的关系。

The relationship of personal assistance service utilization to other Medicaid payments among working-age adults with disabilities.

作者信息

Hashemi Lobat, Henry Alexis D, Ellison Marsha Langer, Banks Steven M, Glazier Raymond E, Himmelstein Jay

机构信息

Center for Health Policy and Research, University of Massachusetts Medical School, Shrewsbury, MA 01545, USA.

出版信息

Home Health Care Serv Q. 2008;27(4):280-98. doi: 10.1080/01621420802581451.

DOI:10.1080/01621420802581451

PMID:19097972

Abstract

This study examined changes in Medicaid provider payments prior to and following approval for personal assistance services (PAS) among 471 PAS users compared to 295 nonusers who qualified for but did not use PAS, adjusting for differences between users and nonusers using propensity scores. PAS users showed a significantly greater increase in total monthly payments from pre- to post-PAS approval compared to nonusers (35% vs. -9) due to high average monthly payments for PAS ($1325). However, users showed a decrease in non-PAS payments compared to nonusers (1%-9% vs. -9%), with significant decreases in payments for both acute/rehabilitation hospitalizations and for nursing home/other long-term residential stays among users. While costly, savings in other areas may help reduce the net cost of PAS.

摘要

本研究调查了471名获得个人协助服务（PAS）批准的使用者与295名符合条件但未使用PAS的非使用者在批准PAS之前和之后医疗补助提供者支付的变化情况，并使用倾向得分调整使用者和非使用者之间的差异。由于PAS的平均月支付较高（1325美元），与非使用者相比，PAS使用者在PAS批准前后每月总支付的增长显著更大（35%对-9%）。然而，与非使用者相比，使用者的非PAS支付有所减少（1%-9%对-9%），使用者在急性/康复住院和养老院/其他长期居住停留方面的支付均显著减少。虽然成本高昂，但其他领域的节省可能有助于降低PAS的净成本。