TRICARE 延伸护理健康选择计划：军事卫生系统中儿科 ECHO 参保者的流行率和医疗服务利用情况。

TRICARE Extended Care Health Option Program: Prevalence of pediatric ECHO enrollees and healthcare service utilization in the Military Health System.

机构信息

Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.

Center for Health Services Research, Uniformed Services University of the Health Sciences, Bethesda, MD, USA; The Henry M Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD, USA.

出版信息

Disabil Health J. 2023 Jul;16(3):101451. doi: 10.1016/j.dhjo.2023.101451. Epub 2023 Feb 24.

DOI:10.1016/j.dhjo.2023.101451

PMID:36941191

Abstract

BACKGROUND

The Extended Care Health Option (ECHO) Program is a TRICARE program aimed at reducing the disabling effects of chronic medical conditions for beneficiaries of the Department of Defense (DoD) healthcare program. However, little is known about military-connected children enrolled in the program.

OBJECTIVE/HYPOTHESIS: The aim of this study was to examine the demographic makeup of pediatric ECHO beneficiaries and their healthcare claims data. This is the first study to evaluate healthcare utilization of this subset of military dependents.

METHODS

A cross-sectional study was performed evaluating ECHO enrolled pediatric beneficiaries and their health service utilization during 2017-2019. TRICARE claims and military treatment facility (MTF) encounter data were utilized to evaluate health service utilization and identify the most frequently reported ICD-10-CM and CPT codes associated with care for this population.

RESULTS

Of the 2,001,619 dependents aged 0-26 years who received medical care in the Military Health System (MHS) during 2017-2019, 21,588 individuals (1.1%) were enrolled in ECHO. The majority of encounters (65.4%) were provided in the MTFs. Inpatient visits, therapeutic services, and in-home nursing care were the top utilized private sector care services. Outpatient visits encompassed 94.8% of healthcare encounters, and neurodevelopmental disorders were the top principal diagnoses among ECHO beneficiaries.

CONCLUSIONS

With the increasing prevalence of children with medical complexity and developmental delay, the pediatric TRICARE beneficiaries eligible for ECHO will likely continue to rise. Improving services and supports for military children with special healthcare needs is needed to maximize their developmental trajectory.

摘要

背景

ECHO 扩展护理健康选项是一项 TRICARE 计划，旨在减少国防部医疗保健计划受益人的慢性疾病的致残影响。然而，对于参加该计划的军人子女知之甚少。

目的/假设：本研究旨在检查儿科 ECHO 受益人的人口构成及其医疗保健索赔数据。这是第一项评估这部分军事受抚养人医疗保健利用情况的研究。

方法

对 2017-2019 年期间参加 ECHO 的儿科受益人和他们的医疗服务利用情况进行了一项横断面研究。利用 TRICARE 索赔和军事治疗设施 (MTF) 就诊数据评估医疗服务利用情况，并确定与该人群护理相关的最常报告的 ICD-10-CM 和 CPT 代码。

结果

在 2017-2019 年期间在军事卫生系统 (MHS) 接受医疗的 2001619 名 0-26 岁的家属中，有 21588 人（1.1%）参加了 ECHO。大多数就诊（65.4%）在 MTF 提供。住院治疗、治疗服务和家庭护理是私人部门利用最多的服务。门诊就诊占医疗就诊的 94.8%，神经发育障碍是 ECHO 受益人的主要诊断。