Adoption of the AHCPR Clinical Practice Guideline for Smoking Cessation -: A survey of California's HMOs
Adoption of the AHCPR Clinical Practice Guideline for Smoking Cessation -: A survey of California's HMOs
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DOI：
10.1016/s0749-3797(01)00345-2
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发表时间：
2001-10-01
影响因子：
5.5
通讯作者：
McMenamin, S
中科院分区：
文献类型：
--
作者：
Schauffler, HH;Mordavsky, JK;McMenamin, S
目的：我们的目标是评估健康维护组织（HMO）和医疗补助管理式护理（MMC）计划在加州采用1996年AHCPR戒烟临床实践指南的程度。（AHCPR [美国卫生保健政策和研究机构]于1999年更名为AHRQ [卫生保健研究和质量机构]。研究方法：传真调查的13个持牌卫生组织和21 MMC计划在加州在1999年与多达10个后续接触电话，邮件，传真，和/或电子邮件。结果：AHCPR指南的认识是广泛的，和所有卫生组织在加州在1999年提供的覆盖范围至少有一个戒烟治疗。我们发现，加州7%的HMO知道AHCPR指南，但不到一半的人使用它来设计福利或向其网络中的医疗保健提供者分发治疗指南。只有23%的加州健康维护组织提供尼古丁贴片或口香糖，69%的健康维护组织提供至少一种形式的药物治疗和一种类型的咨询来治疗烟草依赖。此外，大多数的HMOs和MMC计划告知其成员有关的戒烟治疗的覆盖面，并告知供应商他们的作用，帮助吸烟者quitted.Conclusion：相当大的进展已经取得了越来越多的有效戒烟治疗在加州的管理式医疗机构在过去的10年。未来的努力和研究必须集中在：（1）采用2000年公共卫生服务关于治疗烟草使用和依赖的临床实践指南，（2）增加购买者对烟草依赖治疗的需求，（3）增加健康计划文件和监测成员吸烟状况，以及（4）增加提供有效的烟草依赖治疗。
Objective: Our objective was to assess the degree to which health maintenance organizations (HMOs) and Medicaid managed care (MMC) plans in California have adopted the 1996 AHCPR Clinical Practice Guideline for Smoking Cessation. (AHCPR [U.S. Agency for Health Care Policy and Research] was renamed AHRQ [Agency for Healthcare Research and Quality] in 1999.)Methods: A fax survey of 13 licensed HMOs and 21 MMC plans operating in California in 1999 with up to 10 follow-up contacts by telephone, mail, fax, and/or electronic mail.Results: Awareness of the AHCPR guideline is widespread, and all HMOs in California in 1999 offered coverage for at least one treatment for smoking cessation. We found that 7% of the HMOs in California were aware of the AHCPR guideline, but less than half had used it to design benefits or distribute treatment guidelines to medical care providers in their networks. While only 23% of California HMOs covered the nicotine patch or gum, 69% covered at least one form of the pharmacotherapy and one type of counseling to treat tobacco dependence. In addition, a majority of the HMOs and MMC plans inform their members about coverage for smoking cessation treatments and inform providers about their role in helping smokers to quit.Conclusion: Considerable progress has been made in increasing access to effective smoking cessation treatments in California's managed care organizations over the last 10 years. Future efforts and research must concentrate on: (1) adopting the 2000 Public Health Service Clinical Practice Guideline on Treating Tobacco Use and Dependence, (2) increasing purchaser demand for coverage of tobacco dependence treatments, (3) increasing health plan documentation and monitoring of member smoking status, and (4) increasing provider provision of effective tobacco dependence treatments.