National Use of Safety-Net Clinics for Primary Care among Adults with Non-Medicaid Insurance in the United States
National Use of Safety-Net Clinics for Primary Care among Adults with Non-Medicaid Insurance in the United States
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DOI：
10.1371/journal.pone.0151610
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发表时间：
2016-03-30
期刊：
影响因子：
3.7
通讯作者：
Halm, Ethan A.
中科院分区：
文献类型：
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作者：
Oanh Kieu Nguyen;Makam, Anil N.;Halm, Ethan A.
目的描述非医疗补助保险成年人（即，使用2006-2010年全国门诊医疗调查，在美国的门诊就诊的年度概率样本，我们估计使用加权百分比来解释复杂的调查设计的安全网访问的全国流行率的横断面分析。我们进行了双变量和多变量logistic回归分析，以检查与安全网诊所use.ResultsMore三分之一（35.0%）的所有初级保健安全网诊所访问的特征与非医疗补助主要保险的成年人，代表全国每年访问6,642,000。非医疗补助保险成年人使用安全网的最强预测因素是：来自一个高度贫困的社区（AOR 9.53，95% CI 4.65-19.53），具有Medicare和Medicaid双重资格（AOR 2.13，95% CI 1.38-3.30），黑人（AOR 1.97，95% CI 1.06-3.66）或西班牙裔（AOR 2.28，95% CI 1.32-3.93）。与非安全网使用者相比，使用安全网诊所的非医疗补助保险成年人的糖尿病患病率更高（23.5%对15.0%，p
ObjectiveTo describe the prevalence, characteristics, and predictors of safety-net use for primary care among non-Medicaid insured adults (i.e., those with private insurance or Medicare).MethodsCross-sectional analysis using the 2006-2010 National Ambulatory Medical Care Surveys, annual probability samples of outpatient visits in the U.S. We estimated national prevalence of safety-net visits using weighted percentages to account for the complex survey design. We conducted bivariate and multivariate logistic regression analyses to examine characteristics associated with safety-net clinic use.ResultsMore than one-third (35.0%) of all primary care safety-net clinic visits were among adults with non-Medicaid primary insurance, representing 6,642,000 annual visits nationally. The strongest predictors of safety-net use among non-Medicaid insured adults were: being from a high-poverty neighborhood (AOR 9.53, 95% CI 4.65-19.53), being dually eligible for Medicare and Medicaid (AOR 2.13, 95% CI 1.38-3.30), and being black (AOR 1.97, 95% CI 1.06-3.66) or Hispanic (AOR 2.28, 95% CI 1.32-3.93). Compared to non-safety-net users, non-Medicaid insured adults who used safety-net clinics had a higher prevalence of diabetes (23.5% vs. 15.0%, p