残疾人青少年和年轻人的损伤类型和组合：科罗拉多州 2014-2018 年。
Impairment Types and Combinations Among Adolescents and Young Adults with Disabilities: Colorado 2014-2018.
机构信息
Division of General Pediatrics (AT Chien and SL Toomey), Boston Children's Hospital, Boston, Mass; Department of Pediatrics (AT Chien and SL Toomey), Harvard Medical School, Boston, Mass.
Department of Neurology (SJ Spence), Boston Children's Hospital, Boston, Mass.
出版信息
Acad Pediatr. 2024 May-Jun;24(4):587-595. doi: 10.1016/j.acap.2023.10.010. Epub 2023 Nov 2.
OBJECTIVE
Understanding the types of functional challenges faced by adolescents and young adults with disabilities (AYA-WD) can help payers, clinicians, community-based service providers, and policymakers recognize and meet needs. This paper describes state-level prevalence rates for 1) AYA-WD overall and for 2) impairment types singly and in combinations; and 3) examines how rates may differ between those insured by Medicaid versus commercial insurance.
METHODS
This descriptive study uses Colorado's All Payer Claims Dataset 2014-2018 to identify insured 10- to 26-year-olds (Medicaid only: 333,931; commercially only: 392,444). It then applies the previously validated Children with Disabilities Algorithm (CWDA) and its companion, the Diagnosis-to-Impairment-Type Algorithm (DITA), to compare state-level prevalence rates by insurance source for disability overall and for each of five impairment types singly and in combination.
RESULTS
Disability prevalence was greater among the Medicaid-insured AYA-WD by +7.6% points (pp)-Medicaid: 11.9% (47,654/333,931), commercial: 4.3% (16,907/392,444). Most AYA-WD had a single impairment, but the prevalence of AYA-WD with two or more impairments was greater among the Medicaid-insured than the commercially insured (+9.9 pp; Medicaid: 33.5% [15,963/47,654], commercial: 23.7% [3992/16, 907]), as was the prevalence of impairment types that were physical (+6.7 pp; Medicaid: 54.7% [26,054/47,654], commercial: 48.0% [8121/16,907]); developmental (+4.1 pp; Medicaid: 35.4% [16,874/47,654], commercial: 31.3% [5290/16,907]); psychiatric (+6.7 pp; Medicaid 21.3% [10,175/47,654], commercial: 14.6% [2470/16,907]), and intellectual (+9.3 pp; Medicaid: 26.2% [12,501/47,654], commercial: 16.9% [2858/16,907]).
CONCLUSIONS
CWDA and DITA can be used to understand the rates at which impairment types and combinations occur in a population with childhood-onset disabilities.
目的
了解残疾青少年和年轻人（AYA-WD）面临的功能障碍类型，有助于支付方、临床医生、社区服务提供商和政策制定者认识和满足需求。本文描述了 1）AYA-WD 的总体州级流行率，2）每种和多种组合的残疾类型的流行率；并 3）检查了在 Medicaid 和商业保险覆盖的人群中，这些比率可能有何不同。
方法
本描述性研究使用科罗拉多州的全支付者索赔数据集 2014-2018 来确定有保险的 10-26 岁人群（仅 Medicaid：333931 人；仅商业保险：392444 人）。然后，它应用了先前经过验证的儿童残疾算法（CWDA）及其配套的诊断到残疾类型算法（DITA），以比较按保险来源划分的残疾总体和每种残疾类型的单一和组合的州级流行率。
结果
与商业保险覆盖的 AYA-WD 相比， Medicaid 覆盖的 AYA-WD 的残疾流行率高出+7.6%（点）-Medicaid：11.9%（47654/333931），商业：4.3%（16907/392444）。大多数 AYA-WD 只有一种残疾，但 Medicaid 覆盖的人群中，两种或多种残疾的 AYA-WD 比商业保险覆盖的人群更常见（+9.9%； Medicaid：33.5%[15，963/47654]，商业：23.7%[3992/16，907]），而 Medicaid 覆盖的人群中，物理性残疾（+6.7%； Medicaid：54.7%[26，054/47654]，商业：48.0%[8121/16，907]）、发育障碍（+4.1%； Medicaid：35.4%[16，874/47654]，商业：31.3%[5290/16，907]）、精神疾病（+6.7%； Medicaid：21.3%[10，175/47654]，商业：14.6%[2470/16，907]）和智力障碍（+9.3%； Medicaid：26.2%[12，501/47654]，商业：16.9%[2858/16，907]）的流行率更高。
结论
CWDA 和 DITA 可用于了解具有儿童期发病残疾的人群中各种残疾类型和组合的发生率。
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