在参加按服务收费的联邦医疗保险的老年受益人中，接受家庭医疗护理的情况。
Receipt Of Home-Based Medical Care Among Older Beneficiaries Enrolled In Fee-For-Service Medicare.
机构信息
Jennifer M. Reckrey (
Mia Yang is an assistant professor of internal medicine and geriatrics and gerontology at the Wake Forest University School of Medicine, in Winston-Salem, North Carolina.
出版信息
Health Aff (Millwood). 2020 Aug;39(8):1289-1296. doi: 10.1377/hlthaff.2019.01537.
Millions of older Americans are homebound and may benefit from home-based medical care. We characterized the receipt of this care among community-dwelling, fee-for-service Medicare beneficiaries ages sixty-five and older surveyed in the National Health and Aging Trends Study between 2011 and 2017. Five percent of those surveyed received any home-based medical care between 2011 and 2017 (mean follow-up time per person was 3.4 years), and 75 percent of home-based medical care recipients were homebound. Only 11 percent of the total homebound population (approximately 4.4 million fee-for-service Medicare beneficiaries in 2017) received any home-based medical care between 2011 and 2017. Receipt of home-based medical care was more common among homebound beneficiaries living in metropolitan areas and assisted living facilities, which suggests that geographic factors create operational efficiencies for home-based medical care practices that may improve their financial sustainability within the fee-for-service reimbursement setting. The significant unmet needs of this high-need, high-cost population and the known health and cost benefits of home-based medical care should spur stakeholders to expand the availability of this care.
数以百万计的美国老年人行动不便，可能受益于上门医疗服务。我们对 2011 年至 2017 年间参与国家健康老龄化趋势研究的、按服务收费的 Medicare 受偿者中，居住在社区的 65 岁及以上的人群进行了这项服务的接受情况调查。在 2011 年至 2017 年间，有 5%的调查对象接受了任何上门医疗服务（每人的平均随访时间为 3.4 年），其中 75%的上门医疗服务接受者行动不便。只有 11%的行动不便人群（2017 年约为 440 万按服务收费的 Medicare 受偿者）在 2011 年至 2017 年间接受了任何上门医疗服务。居住在大都市和辅助生活设施中的行动不便的按服务收费 Medicare 受偿者更有可能接受上门医疗服务，这表明地理因素为上门医疗服务实践创造了运营效率，这可能会提高它们在按服务收费报销环境中的财务可持续性。对于这个高需求、高成本的人群来说，这种服务的巨大未满足需求以及上门医疗服务的已知健康和成本效益，应该促使利益相关者扩大这种服务的可及性。
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