Association Between Insurer Connectivity in Appalachian Population Health Networks and Preventable Hospitalizations: Evidence from Kentucky.
Association Between Insurer Connectivity in Appalachian Population Health Networks and Preventable Hospitalizations: Evidence from Kentucky.
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DOI：
10.13023/jah.0502.03
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发表时间：
2023
影响因子：
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通讯作者：
Mays, Glen P
中科院分区：
文献类型：
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作者：
Hogg-Graham, Rachel;Gatton, Kelsey R;Ingram, Rick;Mays, Glen P
满足复杂的卫生和社会需求需要跨部门合作，在社区一级提供医疗、社会和人口卫生服务。在阿巴拉契亚等地区，由于农村化和健康状况和社会后果持续不佳的综合影响，社区卫生和社会服务网络的能力可能受到限制。为低资源社区提供服务的跨部门网络扩大其能力的一种方式是让健康保险公司等合作伙伴参与进来，这些合作伙伴可以利用当地以外的资源。本研究探讨了跨肯塔基州的地理区域的跨部门网络中的保险公司连接性，以及连接性与个人经历可预防的住院治疗的概率之间的关联。使用了一种横断面设计，将国家公共卫生系统纵向调查（NALISHMENT）的数据与2018年肯塔基州患者出院数据联系起来，以检查社区网络中的保险公司连接与城市，农村非阿巴拉契亚地区和阿巴拉契亚地区的可预防住院之间的关联。对数据的分析显示，社区网络中的保险公司连接与可预防的住院之间的关联存在很大的地理差异。阿巴拉契亚农村社区的保险公司连通性与个人因可预防的住院治疗而入院的可能性较低相关（p < 0.01）。研究结果表明，保险公司在跨部门社区卫生和社会服务网络中的连通性有可能加强网络能力，以解决可预防的住院问题，并改善阿巴拉契亚人民的健康状况和福祉。
Addressing complex health and social needs requires cross-sector collaboration to deliver medical, social, and population health services at the community level. Capacity in community health and social services networks may be constrained in regions like Appalachia due to the combined effects of rurality and persistently poor health and social outcomes. One way that cross-sector networks serving low-resource communities can expand their capacity is by engaging partners, like health insurers, who can leverage resources from outside the local area. This study examines insurer connectivity in cross-sector networks across Kentucky’s geographic regions and the association between connectivity and the probability of an individual experiencing a preventable hospitalization. A cross-sectional design was used that linked data from the National Longitudinal Survey of Public Health Systems (NALSYS) with 2018 patient-level Kentucky hospital discharge data to examine the association between insurer connectivity in community networks and preventable hospitalizations across urban, rural non-Appalachian, and Appalachian regions. Analysis of the data shows substantial geographic variation in the association between insurer connectivity in community networks and preventable hospitalization. Insurer connectivity in rural Appalachian communities was associated with lower likelihood that an individual was admitted for a preventable hospitalization ( p < 0.01). Findings suggest insurer connectivity in cross-sector community health and social services networks has the potential to strengthen network capacity to address preventable hospitalizations and improve health outcomes and well-being for the people of Appalachia.