Effects of an Integrated Care System on Quality of Care and Satisfaction for Children with Special Health Care Needs
Effects of an Integrated Care System on Quality of Care and Satisfaction for Children with Special Health Care Needs
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DOI：
10.1007/s10995-011-0778-9
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发表时间：
2012-04-01
影响因子：
2.3
通讯作者：
Shenkman, Elizabeth
中科院分区：
文献类型：
--
作者：
Knapp, Caprice;Madden, Vanessa;Shenkman, Elizabeth
评估综合护理系统（ICS）对有特殊卫生保健需求儿童（CSHCN）家长报告的护理质量和满意度的影响。2006年，佛罗里达州改革了布劳沃德和杜瓦尔县的医疗补助计划。儿童医疗服务网（CMSN）选择参与改革，并为CSHCN开发了ICS。ICS带来了一些变化，如更多的事先批准要求和关闭供应商网络。2006年和2007年分别对改革区县儿童家长和非改革区县儿童家长进行电话调查（n = 1727）。多变量准实验模型的结果表明，父母报告质量的一个组成部分，客户服务，增加了。ICS实施后，客户服务增加了0.22分。实施ICS后，家长报告的质量和满意度一般不受影响。尽管在大多数质量和满意度领域没有看到显著的增长，但令人鼓舞的是，父母没有报告对ICS的负面体验。重要的是要提出这些临时发现，以便监测进展情况，决策者可以开始考虑是否应该在全州范围内扩大该计划。
To assess the effects of an Integrated Care System (ICS) on parent-reported quality of care and satisfaction for Children with Special Health Care Needs (CSHCN). In 2006 Florida reformed its Medicaid program in Broward and Duval counties. Children's Medical Services Network (CMSN) chose to participate in the reform and developed an ICS for CSHCN. The ICS ushered in several changes such as more prior approval requirements and closing of the provider network. Telephone surveys were conducted with CMSN parents whose children reside in the reform counties and parents whose children reside outside of the reform counties in 2006 and 2007 (n = 1,727). Results from multivariate quasi-experimental models show that one component of parent-report quality of care, customer service, increased. Following implementation of the ICS, customer service increased by 0.22 points. After implementation of the ICS, parent-reported quality and satisfaction were generally unaffected. Although significant increases were not seen in the majority of the quality and satisfaction domains, it is nonetheless encouraging that parents did not report negative experiences with the ICS. It is important to present these interim findings so that progress can be monitored and decision-makers can begin to consider if the program should be expanded statewide.