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脊髓损伤患者的保险福利覆盖范围:确定不同付款方之间的差异。

Insurance benefits coverage for persons with spinal cord injuries: determining differences across payors.

作者信息

Tate D G, Forchheimer M, Daugherty J, Maynard F

机构信息

SCI Service, University of Michigan.

出版信息

J Am Paraplegia Soc. 1993 Apr;16(2):76-80. doi: 10.1080/01952307.1993.11735888.

Abstract

This investigation represents a preliminary step in determining differences in benefits coverage among three types of rehabilitation insurance payors (Catastrophic payors, which include Automobile No-Fault and Workers' Disability Compensation; Medicaid; and Third-party private payors). Subjects in this study were 122 spinal cord injury (SCI) outpatients who received their initial rehabilitation at the University of Michigan Medical Center and at the Rehabilitation Institute of Michigan. Insurance benefits received by them were examined across the following areas: accessible housing, transportation, personal attendant care services, professional outpatient services and adapted equipment. Results indicated differences across the three payors, with catastrophically-sponsored SCI outpatients receiving more benefits than SCI outpatients sponsored by public Medicaid or by private third-party insurance. Implications and recommendations for further studies are briefly discussed.

摘要

本调查是确定三类康复保险支付方(灾难性支付方,包括汽车无过失保险和工人伤残补偿;医疗补助;以及第三方私人支付方)在福利覆盖方面差异的初步步骤。本研究的受试者为122名脊髓损伤(SCI)门诊患者,他们在密歇根大学医学中心和密歇根康复研究所接受了初次康复治疗。对他们获得的保险福利在以下方面进行了检查:无障碍住房、交通、个人护理服务、专业门诊服务和适配设备。结果表明,三类支付方之间存在差异,由灾难性保险资助的SCI门诊患者比由公共医疗补助或私人第三方保险资助的SCI门诊患者获得更多福利。本文简要讨论了进一步研究的意义和建议。

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