Children With Medical Complexity And Medicaid: Spending And Cost Savings
Children With Medical Complexity And Medicaid: Spending And Cost Savings
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DOI：
10.1377/hlthaff.2014.0828
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发表时间：
2014-12-01
期刊：
影响因子：
9.7
通讯作者：
Feudtner, Chris
中科院分区：
文献类型：
--
作者：
Berry, Jay G.;Hall, Matt;Feudtner, Chris
一个小但不断增长的人口与医疗复杂性的儿童，其中许多人是由医疗补助，占很高的比例儿科医疗保健支出。我们首先描述了医疗复杂性的儿童医疗保险的医疗费用在整个护理连续体。我们报告说，相对于初级保健和家庭保健的少量支出，这些儿童的医院护理支出越来越多。然后，我们提出了一个商业案例，估计如何节省成本可能实现的医疗复杂性的儿童从潜在的减少医院和急诊室的使用，并显示如何节省可以承保门诊和社区护理的投资。最后，我们讨论了医疗补助的护理质量和医疗保健改革的背景下，这些发现的重要性。
A small but growing population of children with medical complexity, many of whom are covered by Medicaid, accounts for a high proportion of pediatric health care spending. We first describe the expenditures for children with medical complexity insured by Medicaid across the care continuum. We report the increasingly large amount of spending on hospital care for these children, relative to the small amount of primary care and home care spending. We then present a business case that estimates how cost savings might be achieved for children with medical complexity from potential reductions in hospital and emergency department use and shows how the savings could underwrite investments in outpatient and community care. We conclude by discussing the importance of these findings in the context of Medicaid's quality of care and health care reform.