Gill J M
Department of Family and Community Medicine, Medical Center of Delaware, Wilmington, USA. gill.j/med.gen.de.us
Fam Med. 1997 Mar;29(3):166-71.
This study sought to determine whether Medicaid patients with a regular source of care (RSOC) are less likely to be hospitalized, either for all conditions or for ambulatory care sensitive conditions (ACSCs), than those without an RSOC.
This population-based survey study examined Delaware Medicaid patients ages 0-64 over a 1-year period from September 1992 to August 1993 (n = 22,862). Patients who had made more than 50% of their physician office visits to the same provider group were considered to have an RSOC. The probability of hospitalization for all conditions and for ACSCs was compared for persons with and without an RSOC.
Eighty-one percent of Medicaid clients had an RSOC, 75% of whom were primary care physicians. Persons with an RSOC were not less likely than those without an RSOC to be hospitalized for any condition (15% versus 14.6%) or for ACSCs (3.4% versus 3.2%). The results were not substantially different for persons who used primary care physicians as their RSOC.
Having an RSOC is not associated with a lower likelihood of hospitalization for the Medicaid population, either for all conditions or for ACSCs. While providing access to care may have other positive benefits, simply providing Medicaid patients with an RSOC is unlikely to result in a short-term reduction in hospital admissions.
本研究旨在确定有常规医疗来源(RSOC)的医疗补助患者与无RSOC的患者相比,是否因所有疾病或门诊医疗敏感疾病(ACSC)而住院的可能性更低。
这项基于人群的调查研究在1992年9月至1993年8月的1年时间里,对特拉华州0至64岁的医疗补助患者进行了调查(n = 22,862)。超过50%的门诊就诊是在同一医疗服务提供者组进行的患者被视为有RSOC。比较了有和没有RSOC的患者因所有疾病和ACSC住院的概率。
81%的医疗补助客户有RSOC,其中75%是初级保健医生。有RSOC的患者因任何疾病住院(15%对14.6%)或因ACSC住院(3.4%对3.2%)的可能性并不低于没有RSOC的患者。对于将初级保健医生作为RSOC的患者,结果没有实质性差异。
对于医疗补助人群而言,拥有RSOC与因所有疾病或ACSC住院的可能性较低无关。虽然获得医疗服务可能有其他积极益处,但仅仅为医疗补助患者提供RSOC不太可能导致短期住院人数减少。