Primary Care Service Areas: A new tool for the evaluation of primary care services
Primary Care Service Areas: A new tool for the evaluation of primary care services
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DOI：
10.1111/1475-6773.00116
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发表时间：
2003-02-01
影响因子：
3.4
通讯作者：
Carretta, HJ
中科院分区：
文献类型：
--
作者：
Goodman, DC;Mick, SS;Carretta, HJ
目标。开发和描述美国以利用为基础的服务领域，反映医疗保险受益人到初级保健诊所的旅行情况。数据来源/研究背景。1996-1997年B部分和1996年。门诊为65岁及以上的按服务收费的医疗保险受益人提交初级保健索赔。1995年六个州的医疗补助申请(1995)和密歇根州蓝十字蓝盾(1996)的商业索赔。进行了一项患者起源研究以分配。根据大多数受益人对初级保健临床医生的偏好，将1099个美国邮政编码发送到初级保健服务地区。对建立地理毗连性和最低人口和服务本地化进行了调整。通过医疗援助和商业索赔来测试该地区对年轻人口的普遍性。数据收集/提取方法。B部分初级保健索赔是根据提供者专业、服务地点和CPT代码选择的。选择门诊文件索赔使用的提供者编号、设施/服务类型和收入中心代码。主要调查结果。这项研究划定了6,102个初级保健服务区，中位数人口为17,276人(范围为1,005-1,253,240人)。总体而言，63%的医疗保险受益人从他们的初级保健中寻求多元化。区域内的临床医生。服务本地化与医疗补助(6个州)和商业初级保健利用(密歇根州)相比具有可比性，但不是相同的。初级保健服务区域是一种新的工具，用于测量初级保健资源、利用率和。相关结果。司法级别的政策制定者以及研究人员将拥有一个标准化的地理单位系统，通过该系统来评估初级保健服务的获取、获得、供应、使用、组织和筹资。
Objective. To develop and characterize utilization-based service areas for the United States which reflect the travel of Medicare beneficiaries to primary care clinicians.Data Source/Study Setting. The 1996-1997 Part B and 1996. Outpatient File primary care claims for fee-for-service Medicare beneficiaries aged 65 and older. The 1995 Medicaid claims from six states (1995) and commercial claims from Blue Cross Blue Shield of Michigan (1996).Study Design. A patient origin study was conducted to assign. 1099 U.S. zip codes to Primary Care Service Areas on the basis of the plurality of beneficiaries' preference for primary care clinicians. Adjustments Were made to, establish geographic contiguity and minimum population and, service localization. Generality of areas to younger populations was tested with Medic aid and commercial claims.Data Collection/Extraction Methods. Part B primary care claims were selected on the basis of provider specialty, place of service,and CPT code. Selection of Outpatient File claims used provider number, type of facility/service, and revenue center codes.Principal Findings. The study delineated 6,102, Primary Care Service Areas with a median population of 17,276, (range 1,005-1,253,240). Overall, 63 percent of the Medicare beneficiaries sought the plurality of their primary care from. within area clinicians. Service localization compared to Medicaid (six states) and commercial primary care utilization (Michigan) was comparable but not identical.Conclusions. Primary Care Service Area's are a new tool for the measurement of primary care resources, utilization, and. associated outcomes. Policymakers at an jurisdictional levels as well as researchers will have a standardized system of geographical units through which to assess access,to, supply, use, organization, and financing, of primary care services.