The association of payer with utilization of cardiac procedures in Massachusetts.
The association of payer with utilization of cardiac procedures in Massachusetts.
复制标题
马萨诸塞州付款人与心脏手术使用的关联。
DOI：
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发表时间：
1990
期刊：
影响因子：
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通讯作者：
A. Epstein
中科院分区：
文献类型：
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作者：
M. Wenneker;J. Weissman;A. Epstein
为了调查支付者在医院心脏手术使用中的重要性，我们调查了1985年因循环系统疾病或胸痛而入住马萨诸塞州医院的37,994名有医疗补助、私人保险或无保险的患者的护理情况。使用logistic回归控制人口统计学、临床和医院因素，我们发现，私人保险患者接受血管造影术的几率比未保险患者高80%;旁路移植术的几率高40%，血管成形术高28%。医疗补助患者接受血管造影术和搭桥术的几率与未投保患者相似，但接受血管成形术的几率低48%。此外，对于所有三种心脏手术，医疗补助患者的几率低于私人保险患者。这些研究结果表明，保险状况与心脏手术的利用率相关。未来的研究应该确定这些发现对适当性和结果的影响，以及干预措施是否可以改善护理。
To investigate the importance of the payer in the utilization of in-hospital cardiac procedures, we examined the care of 37,994 patients with Medicaid, private insurance, or no insurance who were admitted to Massachusetts hospitals in 1985 with circulatory disorders or chest pain. Using logistic regression to control for demographic, clinical, and hospital factors, we found that the odds that privately insured patients received angiography were 80% higher than uninsured patients; the odds were 40% higher for bypass grafting and 28% higher for angioplasty. Medicaid patients experienced odds similar to those of uninsured patients for receiving angiography and bypass, but had 48% lower odds of receiving angioplasty. In addition, the odds for Medicaid patients were lower than for privately insured patients for all three cardiac procedures. These findings suggest that insurance status is associated with the utilization of cardiac procedures. Future studies should determine the implications these findings have for appropriateness and outcome and whether interventions might improve care.