有功能性听力损失的 Medicare 受益人的医疗保健质量满意度。
Satisfaction With Quality of Health Care Among Medicare Beneficiaries With Functional Hearing Loss.
机构信息
Cochlear Center for Hearing and Public Health, Johns Hopkins University Bloomberg School of Public Health.
Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health.
出版信息
Med Care. 2021 Jan;59(1):22-28. doi: 10.1097/MLR.0000000000001419.
BACKGROUND/OBJECTIVES: Nearly 38 million Americans have hearing loss. Understanding how sensory deficits such as hearing loss, which limit communication, impact satisfaction has implications for Medicare value-based reimbursement mechanisms. The aim of this study was to characterize the association of functional hearing loss and dissatisfaction with quality of health care over the past year among Medicare beneficiaries.
METHODS
Cross-sectional study of satisfaction with quality of health care among Medicare beneficiaries with self-reported trouble hearing from the 2015 Medicare Current Beneficiaries Survey. There were 11,441 Medicare beneficiaries representing a 48.6 million total weighted nationally representative sample.
RESULTS
Forty-eight percent of Medicare beneficiaries reported a little or a lot of trouble hearing. Medicare beneficiaries with a little trouble hearing (odds ratio=1.496; 95% confidence interval, 1.079-2.073; P=0.016) and a lot of trouble hearing (odds ratio=1.769; 95% confidence interval, 1.175-2.664; P=0.007) had 49.6% and 76.9% higher odds of being dissatisfied with the quality of their health care over the previous year, respectively.
CONCLUSIONS
Medicare beneficiaries with functional hearing loss had higher odds of dissatisfaction with health care over the past year compared to those without functional hearing loss. Given Medicare's reliance on patient satisfaction as a value-based measure for hospital reimbursement, interventions to address hearing loss in the health care system are needed.
背景/目的：近 3800 万美国人存在听力损失。了解听力损失等感官障碍如何影响满足感，对医疗保险基于价值的报销机制具有重要意义。本研究旨在描述功能听力损失与过去一年中医疗保险受益人的医疗保健质量不满之间的关联。
方法
对 2015 年医疗保险当前受益人调查中报告有听力困难的医疗保险受益人的医疗保健质量满意度进行横断面研究。共有 11441 名医疗保险受益人，代表了全国具有代表性的 4860 万总加权样本。
结果
48%的医疗保险受益人报告存在轻度或重度听力困难。轻度听力困难的医疗保险受益人（优势比=1.496；95%置信区间，1.079-2.073；P=0.016）和重度听力困难的医疗保险受益人（优势比=1.769；95%置信区间，1.175-2.664；P=0.007）在过去一年中对其医疗保健质量不满意的可能性分别高出 49.6%和 76.9%。
结论
与无功能听力损失的医疗保险受益人相比，有功能听力损失的医疗保险受益人对过去一年的医疗保健不满的可能性更高。鉴于医疗保险将患者满意度作为医院报销的基于价值的衡量标准，需要在医疗保健系统中采取干预措施来解决听力损失问题。
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