Dual utilization of Medicare and VA outpatient care among Veterans with spinal cord injuries and disorders
Dual utilization of Medicare and VA outpatient care among Veterans with spinal cord injuries and disorders
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患有脊髓损伤和疾病的退伍军人双重利用医疗保险和退伍军人管理局门诊护理
DOI：
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发表时间：
2022
期刊：
影响因子：
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通讯作者：
Bridget M. Smith
中科院分区：
文献类型：
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作者：
Maya N Hatch;Bella Etingen;Jason H. Raad;Sameer Siddiqui;K. Stroupe;Bridget M. Smith
目的脊髓损伤和疾病（SCI/D）的退伍军人利用退伍军人事务部的医疗保健设施也符合医疗保险的资格。使用多个医疗保健系统可能会重复或片段照顾这个人群，但很少有人知道那些使用多个系统。这项研究描述了由VA和Medicare支付的SCI/D退伍军人服务的双重使用。设计回顾性、横断面、观察性研究。参与者SCI/D退伍军人（n = 13，902）在VA SCI护理系统内接受医疗服务，并有资格或在2011年参加Medicare。不适用。结果测量患者的特征，平均访问次数和访问的原因，患者水平的频率确定为个人内的医疗保健利用（VA只，医疗保险，或双VA/医疗保险）组。使用多项逻辑回归分析来研究患者变量与双重使用的相关性。结果65.3%的SCI/D的退伍军人是VA的唯一用户的门诊遭遇，4.4%的遭遇支付的医疗保险只，和30.3%的双重用户。退伍军人不太可能是VA只有用户，如果他们年龄超过69岁，如果他们已经受伤超过十年。非裔美国退伍军人与SCI（相比白色）更有可能是VA唯一的用户。结论相当一部分（约30%）的SCI/D退伍军人是双重使用者。这些数字突出了改进战略以协调护理和增加跨系统卫生信息共享的重要性。
Objective Veterans with spinal cord injuries and disorders (SCI/D) utilizing Veterans Affairs healthcare facilities are also Medicare eligible. Use of multiple health care systems potentially duplicates or fragments care in this population; yet little is known about those using multiple systems. This study describes dual use of services paid for by VA and Medicare among Veterans with SCI/D. Design Retrospective, cross-sectional, observational study. Participants Veterans with SCI/D (n = 13,902) who received healthcare services within the VA SCI System of Care and were eligible for or enrolled in Medicare in 2011. Interventions N/A. Outcome Measures Patient characteristics, average number of visits and patient level frequencies of reasons for visits were determined for individuals within healthcare utilization (VA only, Medicare only, or dual VA/Medicare) groups. Multinomial logistic regression analyses were used to investigate associations of patient variables on dual use. Results 65.3% of Veterans with SCI/D were VA only users for outpatient encounters, 4.4% had encounters paid for by Medicare only, and 30.3% were dual users. Veterans were less likely to be VA only users if they were older than 69 and if they had been injured for greater than ten years. African American Veterans with SCI (compared to white) were more likely to be VA only users. Conclusion A substantial number (∼30%) of Veterans with SCI/D are dual users. These numbers highlight the importance of improved strategies to coordinate care and increase health information sharing across systems.
急性脊髓损伤的早期处理 - 第一部分：手术初期损伤。
影响因子：
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作者：
Sacino,Amanda;Rosenblatt,Kathryn
通讯作者：
Rosenblatt,Kathryn