Effects of outcome-driven insurance reimbursement on short-term weight control
Effects of outcome-driven insurance reimbursement on short-term weight control
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DOI：
10.1038/sj.ijo.0802403
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发表时间：
2003-11-01
影响因子：
4.9
通讯作者：
Heimburger, DC
中科院分区：
文献类型：
--
作者：
Hubbert, KA;Bussey, BF;Heimburger, DC
背景：虽然大多数健康保险公司不包括体重控制治疗，一家当地保险公司提供部分费用报销的体重控制方案，采用激励计划。目的：确定结果驱动的基于保险公司的报销是否能改善参与体重控制计划和短期减肥结果。设计：1998年1月至2001年2月的队列随访研究。环境：由学术医疗中心运营的社区体重管理项目。受试者：有可能报销的肥胖参与者（A组，n = 25）和没有可能报销的同一项目班级的参与者（B组，n = 100）。B组的受试者是从206名潜在参与者中选择的，使用倾向评分将他们与a组的受试者在年龄、性别、种族、起始BMI、起始体重以及教育、经济和人口统计学变量上进行匹配。干预：基于群体生活方式的体重管理计划。保险公司向符合最低体重标准的肥胖参与者报销一半的费用，这些参与者在注册时支付了项目费用，参加了12节课中10节以上的课程，并在12周后减掉了超过或等于初始体重6%的体重。主要结果测量：参与率和减肥结果。结果：A组受试者上课时间明显多于对照组（平均+/-s）。d: 10.1 +/- 1.8 vs 8.2 +/- 2.5， P
CONTEXT: Although most health insurers exclude coverage of weight control therapy, one local insurer offered partial reimbursement of the cost of a weight control program, using an incentive plan.OBJECTIVE: To determine whether outcome-driven insurer-based reimbursement improves participation in a weight control program and short-term weight loss outcomes.DESIGN: Cohort follow-up study between January 1998 and February 2001.SETTING: Community weight management program operated by an academic medical center.SUBJECTS: Obese participants who had the potential for reimbursement ( Group A, n = 25) and participants in the same program classes ( Group B, n = 100) who had no possibility for reimbursement. Subjects in Group B were selected from among 206 potential participants using a propensity score to match them with subjects in Group A on age, gender, ethnicity, starting BMI, starting weight, and educational, economic, and demographic variables.INTERVENTION: Group lifestyle-based weight management program. The insurer reimbursed half the cost of the program to obese participants who met minimum weight criteria, paid the program fee at enrollment, attended greater than or equal to10 of the 12 classes, and lost greater than or equal to6% of initial body weight after 12 weeks.MAIN OUTCOME MEASURES: Participation rates and weight loss outcomes.RESULTS: Group A subjects attended significantly more classes (mean+/-s. d.: 10.1 +/- 1.8 vs 8.2 +/- 2.5, P