Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Baltimore, MD 21205, USA.
J Community Health. 2013 Apr;38(2):301-9. doi: 10.1007/s10900-012-9615-3.
The Healthy Howard Health Plan (HHHP) is an innovative health access plan providing healthcare and health coaching to previously uninsured adults in Howard County, Maryland. HHHP members who enrolled in HHHP between January 2009 to June 2010 are followed over time using a variety of self-reported data collection tools including a health risk assessment (HRA), the SF-12, a measure of health status, and the PAM, patient activation measure. We describe their unmet health needs, demographics, health status and behaviors at baseline and we describe changes in health-related behaviors over time. Demographic and baseline HRA results for 700 individuals who enrolled over the first 18 months reveal HHHP members generally were racially diverse (white: 37 %; African American: 23 %, and Asian: 30 %), married (50 %) females (59 %). Most (62 %) have a family income between 121 and 200 % of the federal poverty level, and were without health insurance for more than 1 year (56 %). Self-reported health and behaviors for 163 plan members who completed initial and follow up HRAs revealed increases in physical activity, fruit and vegetable consumption, and health status. Statistically significant differences were found in patient activation from baseline to follow up (44 vs 58 %, p value 0.0005). Patient demographics, health status, and health behaviors of these newly insured Americans may help policy makers and care providers prepare to meet their needs. We noted improvements in certain self-reported health behaviors and health status, suggesting participation in the Plan is associated with positive health impacts for some Plan members.
霍华德健康计划（HHHP）是一项创新的健康保险计划，为马里兰州霍华德县以前没有医疗保险的成年人提供医疗保健和健康指导。HHHP 会员于 2009 年 1 月至 2010 年 6 月期间加入 HHHP 后，通过多种自我报告数据收集工具进行跟踪，包括健康风险评估（HRA）、SF-12 健康状况衡量标准和 PAM 患者激活测量。我们描述了他们未满足的健康需求、人口统计学、基线时的健康状况和行为，并描述了随着时间的推移健康相关行为的变化。在最初的 18 个月内，有 700 名参加者的人口统计学和基线 HRA 结果显示，HHHP 会员通常具有多样化的种族背景（白人：37%；非裔美国人：23%，和亚洲人：30%）、已婚（50%）女性（59%）。大多数（62%）人的家庭收入处于联邦贫困线的 121%至 200%之间，并且有超过 1 年没有医疗保险（56%）。163 名完成初始和后续 HRA 的计划成员的自我报告健康和行为显示，他们的身体活动、水果和蔬菜摄入量以及健康状况有所增加。从基线到随访，患者激活方面的差异具有统计学意义（44%对 58%，p 值<0.0005）。这些新参保美国人的患者人口统计学、健康状况和健康行为可能有助于政策制定者和医疗服务提供者为满足他们的需求做好准备。我们注意到某些自我报告的健康行为和健康状况有所改善，这表明参与该计划与某些计划成员的健康积极影响有关。
