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医疗专业人员对减肥服务保险覆盖范围的看法。

Health Professionals' perceptions of insurance coverage for weight loss services.

作者信息

Doshi R S, Bleich S N, Gudzune K A

机构信息

Johns Hopkins Bloomberg School of Public Health Baltimore USA.

Johns Hopkins University School of Medicine Baltimore USA.

出版信息

Obes Sci Pract. 2017 Nov 21;3(4):384-389. doi: 10.1002/osp4.137. eCollection 2017 Dec.

Abstract

OBJECTIVE

To examine health professionals' (HPs) perceptions of top challenges and solutions in obesity care, and whether these perceptions differ by patient-panel income level.

METHODS

A 2014 national cross-sectional survey of HPs in nutrition, nursing, behavioural or mental health, exercise and pharmacy was analysed. The dependent variables were identification of insurance coverage for their services as a top (1) challenge or (2) solution for obesity care. The independent variable was self-reported income distribution of HPs' patient panels, which was dichotomized as 'lower-income' if 'mostly low income' or 'higher-income' if 'mostly not low income/evenly split between low-income and not low-income'. Multivariate logistic regression with survey weights was used.

RESULTS

Among 450 HPs, mean age was 44.9 years; 86% were women; 44% had lower-income panels. Overall, 25% of HPs endorsed insurance coverage as a current challenge, and 58% viewed improved coverage as a solution. HPs with lower and higher-income patient panels were similarly likely to identify coverage as a challenge (28% vs. 20%, p = 0.33) and benefits expansion as a solution (47% vs. 64%, p = 0.08).

CONCLUSIONS

Most HPs perceive insurance coverage for their services to benefit patient weight loss. While the Affordable Care Act expands obesity counselling coverage to many lower-income patients, legislation increasing access to benefits for all patients regardless of insurance type may be beneficial.

摘要

目的

研究医疗保健专业人员(HPs)对肥胖症护理中主要挑战及解决方案的看法,以及这些看法是否因患者群体收入水平而异。

方法

对2014年全国范围内营养、护理、行为或心理健康、运动及药学领域的医疗保健专业人员进行的横断面调查进行分析。因变量为将其服务的保险覆盖范围确定为肥胖症护理的首要(1)挑战或(2)解决方案。自变量为医疗保健专业人员自我报告的患者群体收入分布情况,若为“大多为低收入”则分为“低收入”,若为“大多非低收入/低收入与非低收入均衡分布”则分为“高收入”。采用加权的多变量逻辑回归分析。

结果

在450名医疗保健专业人员中,平均年龄为44.9岁;86%为女性;44%的患者群体为低收入。总体而言,25%的医疗保健专业人员认可保险覆盖范围是当前的一项挑战,58%的人认为改善保险覆盖范围是一种解决方案。低收入和高收入患者群体的医疗保健专业人员同样有可能将保险覆盖范围视为一项挑战(28%对20%,p = 0.33),并将扩大福利视为一种解决方案(47%对64%,p = 0.08)。

结论

大多数医疗保健专业人员认为其服务的保险覆盖范围有利于患者减肥。虽然《平价医疗法案》将肥胖症咨询保险覆盖范围扩大到许多低收入患者,但立法增加所有患者(无论保险类型)获得福利的机会可能会有益处。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a96b/5729498/b9d613ad512f/OSP4-3-384-g001.jpg

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