医疗补助覆盖不一致与癫痫患者的负面健康事件有关。
Inconsistent Medicaid Coverage is Associated with Negative Health Events for People with Epilepsy.
出版信息
J Health Care Poor Underserved. 2022;33(2):1036-1053. doi: 10.1353/hpu.2022.0079.
OBJECTIVE
Examine the association between gaps in Medicaid coverage and negative health events (NHEs) for people with epilepsy (PWE).
METHODS
Using five years of Medicaid claims for PWE, we identified gaps in Medicaid coverage. We used logistic regression to evaluate the association between a gap in coverage and being in the top quartile of NHEs and factors associated with having a gap. These models adjusted for: demographics, residence, medication adherence, disease severity, and comorbidities.
RESULTS
Of 186,616 PWE, 21.7% had a gap in coverage. The odds of being in the top quartile of NHEs per year were 66% higher among those with a gap (OR: 1.66; 95% CI: 1.61, 1.70). Being female, younger, and having psychiatric comorbidities increased the odds of having a gap.
CONCLUSIONS
Gaps in Medicaid coverage are associated with being a high utilizer during covered periods. Specific groups could be targeted with interventions to reduce churning.
目的
研究医疗补助（Medicaid）覆盖缺口与癫痫患者（PWE）负面健康事件（NHEs）之间的关联。
方法
我们使用五年的 PWE 医疗补助索赔数据，确定了 Medicaid 覆盖缺口。我们使用逻辑回归评估覆盖缺口与处于 NHEs 前四分之一的可能性之间的关联，以及与存在覆盖缺口相关的因素。这些模型调整了人口统计学、居住地、药物依从性、疾病严重程度和合并症。
结果
在 186616 名 PWE 中，21.7%存在 Medicaid 覆盖缺口。与没有覆盖缺口的人相比，每年处于 NHEs 前四分之一的可能性高出 66%（OR：1.66；95%CI：1.61，1.70）。女性、年龄较小和患有精神科合并症的患者更有可能存在覆盖缺口。
结论
Medicaid 覆盖缺口与覆盖期内高利用率有关。可以针对特定群体进行干预，以减少波动。
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