Insurance Status and Quality of Diabetes Care in Community Health Centers
Insurance Status and Quality of Diabetes Care in Community Health Centers
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DOI：
10.2105/ajph.2007.125534
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发表时间：
2009-04-01
影响因子：
12.7
通讯作者：
Chin, Marshall H.
中科院分区：
文献类型：
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作者：
Zhang, James X.;Huang, Elbert S.;Chin, Marshall H.
目标.我们试图比较联邦政府资助的社区卫生中心的糖尿病护理质量的保险类型。我们于2002年从17个州的27个社区卫生中心随机选择了2018名糖尿病患者，将其分为6个相互排斥的保险组。我们使用多变量logistic回归分析比较了6个国家质量保证委员会健康计划雇主数据和信息集糖尿病护理过程和结果测量的糖尿病护理质量。33%的患者没有医疗保险，24%只有医疗保险，15%只有医疗补助，7%有医疗保险和医疗补助，14%有私人保险，7%有其他保险类型。那些没有保险的人是最不可能满足医疗质量的措施;那些有医疗补助的人有一个类似的医疗质量，那些没有保险。需要进行研究，以确定在安全网提供者，如社区卫生中心之间的保险状态的护理质量的差异的主要介质。这种研究是必要的政策干预，在医疗补助福利设计，并作为一种激励措施，以提高护理质量。(Am J公共卫生。2008;99：742-747. doi：10.2105/AJPH.2007.125534）
Objectives. We sought to compare quality of diabetes care by insurance type in federally funded community health centers.Method. We categorized 2018 diabetes patients, randomly selected from 27 community health centers in 17 states in 2002, into 6 mutually exclusive insurance groups. We used multivariate logistic regression analyses to compare quality of diabetes care according to 6 National Committee for Quality Assurance Health Plan Employer Data and Information Set diabetes processes of care and outcome measures.Results. Thirty-three percent of patients had no health insurance, 24% had Medicare only, 15% had Medicaid only, 7% had both Medicare and Medicaid, 14% had private insurance, and 7% had another insurance type. Those without insurance were the least likely to meet the quality-of-care measures; those with Medicaid had a quality of care similar to those with no insurance.Conclusions. Research is needed to identify the major mediators of differences in quality of care by insurance status among safety-net providers such as community health centers. Such research is needed for policy interventions at Medicaid benefit design and as an incentive to improve quality of care. (Am J Public Health. 2008;99:742-747. doi:10.2105/AJPH.2007.125534)