Changes in insurance coverage and extent of care during the two years after first hospitalization for a psychotic disorder
Changes in insurance coverage and extent of care during the two years after first hospitalization for a psychotic disorder
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DOI：
10.1176/appi.ps.52.1.87
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发表时间：
2001-01-01
影响因子：
3.8
通讯作者：
Rosen, B
中科院分区：
文献类型：
--
作者：
Rabinowitz, J;Bromet, EJ;Rosen, B
目的：本研究探讨精神病患者首次入院后24个月内保险覆盖范围的变化以及保险类型与护理程度的关系。方法：样本包括参加萨福克县（纽约）心理健康项目的443人。关于保险范围的信息——私人保险，医疗补助-医疗保险，或者没有保险——是从医院记录和访谈中获得的。比较保险状态组，检查他们接受住院、门诊和日间医院护理的天数百分比的差异。结果和结论：没有保险的人的比例从基线到24个月，从42%下降到21%。拥有私人保险的人的比例保持相似，分别为42%和37%。享受医疗补助-医疗保险的比例从15%上升到42%。在医疗补助-医疗保险的基线（67人）中，88%的人在24个月后获得了这种覆盖。在基线时拥有私人保险的人中（188人），73%的人在24个月后仍然拥有同样的保险。在基线没有保险的人中（188人），35%的人在24个月时没有保险，54%的人有医疗补助-医疗保险，11%的人有私人保险。在过去的24个月里，医疗补助-医疗保险组的护理天数最多，私人保险组的住院护理天数最少，而那些没有保险的人接受门诊治疗的可能性最小。接受更多的门诊治疗与在医院和日间医院花费更少的时间之间存在线性关系。
Objective: This study examined changes in insurance coverage during the 24 months after first admission for a psychotic disorder and the relationship of insurance type to the extent of care. Methods: The sample consisted of 443 persons who were enrolled in the Suffolk County (New York) Mental Health Project. Information about coverage-private insurance, Medicaid-Medicare, or no insurance-was obtained from hospital records and interviews. The insurance status groups were compared to examine differences in the percentage of days they received inpatient, outpatient, and day hospital care. Results and Conclusions: The proportion of persons with no insurance decreased from baseline to 24 months, from 42 percent to 21 percent. The proportion of persons with private insurance remained similar, 42 and 37 percent. The proportion of those with Medicaid-Medicare increased from 15 percent to 42 percent. Of those with Medicaid-Medicare at baseline (67 persons), 88 percent had such coverage 24 months later. Of those with private insurance at baseline (188 persons), 73 percent had the same coverage 24 months later. Of those with no insurance at baseline (188 persons), 35 percent had no insurance at 24 months, 54 percent had Medicaid-Medicare, and 11 percent had private insurance. Over the 24 months, the Medicaid-Medicare group had the most days of care, the private insurance group had the least inpatient care, and those with no insurance were least likely to receive outpatient care. There was a linear relationship between receiving more outpatient care and spending less time in the hospital and the day hospital.