Accountable Care Organizations and Health Disparities of Rural Latinos: A Longitudinal Analysis.
Accountable Care Organizations and Health Disparities of Rural Latinos: A Longitudinal Analysis.
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负责任的医疗组织和农村拉丁裔的健康差异：纵向分析。
DOI：
10.1089/pop.2022.0062
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发表时间：
2022
影响因子：
2.5
通讯作者：
Hofler,Richard
中科院分区：
文献类型：
--
作者：
Ortiz,Judith;Hill,Mitch;Thomas,ChadW;Hofler,Richard
本研究的目的有两个方面：（1）分析农村拉丁裔老年患者与白色患者相比糖尿病相关住院率的变化;（2）确定哪些因素（包括农村健康诊所（RHC）参与责任医疗组织（ACO））与糖尿病相关住院率差异的减少有关。对8年来由RHC服务的拉丁美洲医疗保险受益人的数据进行了分析。首先，进行了均值差异检验，以确定从ACO前阶段（2008-2011）到ACO后阶段（2012-2015）的差异是否发生变化。随着时间的推移，差异在统计学上显著减少（t=-7.6899，df = 115，P< 0.001）。其次，对3个独立的模型进行多元回归分析，以确定ACO参与是否有助于减少拉丁美洲人和白人之间糖尿病相关住院率的差异。分析表明，有中度证据表明，持续的ACO参与与较低的健康差异相关（t=-1.947，P = 0.0525）。然而，在平衡协变量后，这种关联并不显著，无法建立因果关系。拉丁美洲人是美国城乡增长最快的群体之一。至关重要的是，ACO强调护理协调，医疗保健质量和价值，监督他们向拉丁美洲人，农村和其他弱势群体提供的服务。
The purpose of this study was 2-fold: (1) to analyze the change in diabetes-related hospitalization rates of rural Latino older adult patients as compared with their White counterparts and (2) to determine what factors, including rural health clinic (RHC) participation in accountable care organizations (ACOs), are related to reduced disparities in diabetes-related hospitalization rates. Data for Latino Medicare beneficiaries who were served by RHCs over an 8-year period were analyzed. First, a difference-of-means test was conducted to determine whether there was a change in disparity from the pre-ACO period (2008–2011) to the post-ACO period (2012–2015). A statistically significant decrease in disparity over time was found (t= −7.6899, df = 115,P< 0.001.) Second, multiple regression analyses of 3 separate models were conducted to determine whether ACO participation contributed to reducing disparities in diabetes-related hospitalization rates between Latinos and Whites. The analyses indicated moderate evidence that consistent ACO participation is associated with lower health disparities (t= −1.947,P= 0.0525). However, this association is not significant after balancing covariates, and no causal relationship can be established. Latinos compose one of the fastest growing groups in rural as well as urban areas of the United States. It is critical that ACOs, with their emphasis on care coordination, health care quality, and value, monitor their provision of services to Latinos, rural, and other vulnerable populations.
影响因子：
9.7
作者：
Lewis, Valerie A.;Larson, Bridget Kennedy;Fisher, Elliott S.
通讯作者：
Fisher, Elliott S.
影响因子：
5.9
作者：
Hale, Nathan L.;Bennett, Kevin J.;Probst, Janice C.
通讯作者：
Probst, Janice C.
网络中卫生中心的绩效
影响因子：
2.5
作者：
J. Ortiz;M. Fottler;Richard A. Hofler
通讯作者：
Richard A. Hofler