Center for Primary care, Prevention, and Clinical Partnerships Agency for Healthcare Research and Quality, Rockville, MD 20850, USA.
Health Care Manag Sci. 2012 Mar;15(1):15-28. doi: 10.1007/s10729-011-9176-5. Epub 2011 Sep 3.
The study assesses the role of Medicare Advantage (MA) plans in providing quality primary care in comparison to FFS Medicare in three states, New York, California, Florida, across three racial ethnic groups. The performance is measured in terms of providing better quality primary care, as defined by lowering the risks of preventable hospital admissions. Using 2004 hospital discharge data (HCUP-SID) of Agency for Healthcare Research and Quality for three states, a multivariate cross sectional design is used with individual admission as the unit of analysis. The study found that MA plans were associated with lower preventable hospitalizations relative to marker admissions. The benefit also spilled over to different racial and ethnic subgroups and in some states, e.g. CA and FL, MA enrollment was associated with significantly lower odds of minority admissions than of white admissions. These results may indicate a potentially favorable role of MA plans in attenuating racial/ethnic inequalities in primary care in some states.
本研究评估了医疗保险优势计划（MA）在三个州（纽约、加利福尼亚、佛罗里达）的三种种族群体中提供优质初级保健服务的作用，与传统的医疗保险相比。表现是通过降低可预防住院的风险来衡量的，以提供更好的初级保健质量为定义。使用 2004 年三个州的医疗机构资源利用率调查（HCUP-SID）的医疗机构资源利用率调查数据，采用个体入院为分析单位的多变量横截面设计。研究发现，与标志物入院相比，MA 计划与较低的可预防住院率相关。这种好处也扩展到不同的种族和族裔亚组，并且在某些州，例如加利福尼亚州和佛罗里达州，MA 计划的参与与少数民族入院的可能性显著低于白人入院的可能性相关。这些结果可能表明 MA 计划在某些州减轻初级保健中种族/族裔不平等方面可能发挥了有利作用。
