Suppr超能文献

比较患有终末期肾病(ESKD)的医疗保险按服务收费受益人中转向医疗保险优势计划与仍留在传统医疗保险计划的人群。

Comparing Medicare Fee-for-Service Beneficiaries with ESKD Who Switched to Medicare Advantage versus Remained in Traditional Medicare.

作者信息

Gao Allan Y, Knapp Christopher D, Liu Jiannong, Johansen Kirsten L

机构信息

University of Minnesota School of Medicine, Minneapolis, MN.

Department of Medicine, Hennepin Healthcare, Minneapolis, MN.

出版信息

Clin J Am Soc Nephrol. 2024 Sep 1;19(9):1183-1190. doi: 10.2215/CJN.0000000000000512. Epub 2024 Jul 16.

Abstract

Patients choosing Medicare Advantage versus Medicare fee-for-service (FFS) differ with respect to race, socioeconomic status, and burden of disease. However, it is unclear whether these differences also occur among patients with kidney failure, who were newly allowed to switch to Medicare Advantage after the 21st Century Cares Act. We used data from the United States Renal Data System to examine differences in characteristics of dialysis patients and kidney transplant recipients who switched from FFS to Medicare Advantage compared with those who stayed with FFS in 2021, the first year such switching was allowed. We used unadjusted and adjusted logistic regression to compare odds of switching among demographic and geographic subgroups. Among 411,513 patients with FFS coverage in 2020, 10.1% switched to Medicare Advantage in 2021. Switchers constituted 12% of the dialysis population and 5% of the kidney transplant population. In the dialysis population, patients of Black race and Hispanic ethnicity were more likely to switch than patients of White race (adjusted odds ratio [OR], 1.69; 95% confidence interval [CI], 1.64 to 1.73 and OR, 1.42; 95% CI, 1.40 to 1.47; respectively), as were patients with dual eligibility for Medicaid (adjusted OR, 1.12; 95% CI, 1.09 to 1.15). Patients living in the South were also more likely to switch to Medicare Advantage than those living in the West (adjusted OR, 1.48; 95% CI, 1.43 to 1.52). Similar differences were observed among kidney transplant recipients. Patients who switched from FFS to Medicare Advantage were disproportionately from historically marginalized groups, including Black, Hispanic, and low-income individuals. They were also more likely to live in the South. These differences may threaten the generalizability of United States Renal Data System data that relies on FFS insurance claims and suggest that comparisons of outcomes between FFS and medicare advantage beneficiaries with kidney failure should be adjusted for key patient characteristics.

摘要

选择医疗保险优势计划(Medicare Advantage)而非传统按服务收费医疗保险(Medicare fee-for-service,FFS)的患者在种族、社会经济地位和疾病负担方面存在差异。然而,对于那些在《21世纪关怀法案》之后新获准转而参加医疗保险优势计划的肾衰竭患者中是否也存在这些差异,目前尚不清楚。我们利用美国肾脏数据系统(United States Renal Data System)的数据,研究了2021年(允许进行这种转换的第一年)从FFS转而参加医疗保险优势计划的透析患者和肾移植受者与继续留在FFS的患者在特征上的差异。我们使用未调整和调整后的逻辑回归来比较人口统计学和地理亚组中转换的几率。在2020年有FFS保险的411,513名患者中,10.1%在2021年转而参加了医疗保险优势计划。转换者占透析人群的12%,占肾移植人群的5%。在透析人群中,黑人种族和西班牙裔患者比白人种族患者更有可能转换(调整后的优势比[OR]分别为1.69;95%置信区间[CI]为1.64至1.73和OR为1.42;95%CI为1.40至1.47),同时符合医疗补助双重资格的患者也是如此(调整后的OR为1.12;95%CI为1.09至1.15)。居住在南部的患者也比居住在西部的患者更有可能转而参加医疗保险优势计划(调整后的OR为1.48;95%CI为1.43至1.52)。在肾移植受者中也观察到了类似的差异。从FFS转而参加医疗保险优势计划的患者不成比例地来自历史上被边缘化的群体,包括黑人、西班牙裔和低收入个体。他们也更有可能居住在南部。这些差异可能会威胁到依赖FFS保险理赔的美国肾脏数据系统数据的普遍性,并表明在比较FFS和医疗保险优势计划的肾衰竭受益人的结局时,应针对关键患者特征进行调整。

相似文献

本文引用的文献

2
Medicare advantage and dialysis facility choice.医疗保险优势与透析机构选择。
Health Serv Res. 2023 Oct;58(5):1035-1044. doi: 10.1111/1475-6773.14153. Epub 2023 Mar 22.

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍。

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索

文档翻译

学术文献翻译模型,支持多种主流文档格式。

立即体验