Trends in charges and payments for nonhospitalized emergency department pediatric visits, 1996-2003.
Trends in charges and payments for nonhospitalized emergency department pediatric visits, 1996-2003.
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1996 年至 2003 年非住院急诊科儿科就诊费用和付款的趋势。
DOI：
10.1111/j.1553-2712.2008.00075.x
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发表时间：
2008
期刊：
影响因子：
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通讯作者：
Baker,LaurenceC
中科院分区：
文献类型：
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作者：
Hsia,ReneeY;MacIsaac,Donna;Palm,Erin;Baker,LaurenceC
目的：比较收费和支付门诊儿科急诊就诊跨付款人groups. Methods提供信息报销trends.Methods：总收费和支付急诊科（艾德）访问医疗补助/国家儿童健康保险计划（SCHIP），私人保险，和无保险的儿科患者从1996年至2003年使用的数据从医疗支出小组调查。每次访问的平均费用和每次访问的平均付款也进行了跟踪，使用回归分析，以调整患者的变化characteristics.Results：虽然收费儿科艾德访问随着时间的推移而上升，付款并没有跟上步伐。这导致偿还率从1996年的63%下降到2003年的48%。在所有年份中，医疗补助/SCHIP就诊的报销率最低，2003年达到35%。在审查期间，接受医疗补助/家庭健康保险计划保险的儿童的就诊比例也有所增加。在2003年，调整后，收费为792美元每次访问从医疗补助/SCHIP覆盖的儿童，913美元的访问从无保险的儿童，和952美元的访问从私人insurred children.Conclusions：报销门诊艾德就诊的儿科人口从1996年至2003年期间，在所有付款人群体：公共（医疗补助/SCHIP），私人，和无保险。医疗补助/SCHIP每次就诊的费用一直低于私人保险和未保险的人。进一步的研究，这些下降的补偿对儿童艾德服务的财政可行性的影响是必要的。
Objectives:To compare charges and payments for outpatient pediatric emergency visits across payer groups to provide information on reimbursement trends.Methods:Total charges and payments for emergency department (ED) visits Medicaid/State Children’s Health Insurance Program (SCHIP), privately insured, and uninsured pediatric patients from 1996 to 2003 using data from the Medical Expenditure Panel Survey. Average charges per visit and average payments per visit were also tracked, using regression analysis to adjust for changes in patient characteristics.Results:While charges for pediatric ED visits rose over time, payments did not keep pace. This led to a decrease in reimbursement rates from 63% in 1996 to 48% in 2003. For all years, Medicaid/SCHIP visits had the lowest reimbursement rates, reaching 35% in 2003. The proportion of visits from children insured by Medicaid/SCHIP also increased over the period examined. In 2003, after adjustment, charges were $792 per visit from children covered by Medicaid/SCHIP, $913 for visits from uninsured children, and $952 for visits from privately insured children.Conclusions:Reimbursements for outpatient ED visits in the pediatric population have decreased from the period of 1996 to 2003 in all payer groups: public (Medicaid/SCHIP), private, and the uninsured. Medicaid/SCHIP has consistently paid less per visit than the privately insured and the uninsured. Further research on the effects of these declining reimbursements on the financial viability of ED services for children is warranted.