Trends in Health Disparities of Rural Latinos Pre- and Post-Accountable Care Organization Implementation.
Trends in Health Disparities of Rural Latinos Pre- and Post-Accountable Care Organization Implementation.
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农村拉丁美洲人的健康差异的趋势，可接纳后的护理组织实施。
DOI：
10.1108/s0275-495920220000039013
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发表时间：
2022
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我们报告了一项纵向调查的结果，该调查的目的是比较农村拉丁裔老年糖尿病患者与非拉丁裔白人患者的健康差异。实施了一项前后设计，将农村卫生诊所（RHCs）参与医疗保险责任医疗组织（ACO）作为干预措施，并使用与糖尿病相关的住院治疗来衡量差异。在2008年至2015年的8年研究期间，对全国2683名RHCs的数据进行了分析。此外，研究人员还分析了位于佛罗里达州、德克萨斯州和加利福尼亚州的116个rhc子集的数据，这些rhc在研究期间的一年或更长时间内参加了Medicare ACO。这项调查得出了两个广泛的结论。首先，对于全国范围内的RHCs和三个州的“ACO RHCs”样本，在8年的研究期间，糖尿病相关住院率的平均差异有所减少。其次，在比较2012年Medicare ACO实施后的三年时间与实施前的四年时间，发现全国范围内的平均差距有统计学上的显著差异。近年来，有许多因素可能导致拉丁裔糖尿病相关住院率下降。未来的研究将确定减少拉丁裔与普通人群之间糖尿病相关住院差异的具体因素，包括RHCs参与ACO的可能影响。本文介绍了使用与农村拉丁裔老年人相关的数据进行的原始研究。这些数据代表了多个州和一个8年的时间段。美国拉丁裔人口正在快速增长。作为一个群体，他们患糖尿病的风险很高，糖尿病的并发症对患者和美国医疗系统来说都是严重和昂贵的。随着拉丁裔人口的持续增长，至关重要的是要监测他们的健康差距，并查明和促进有助于他们健康和福祉的因素。
We present findings from a longitudinal investigation, the purpose of which was to compare health disparities of rural Latino older adult patients diagnosed with diabetes to their non-Latino White counterparts. A pre-post design was implemented treating Medicare Accountable Care Organization (ACO) participation by Rural Health Clinics (RHCs) as an intervention, and using diabetes-related hospitalizations to measure disparities. Data for a nationwide panel of 2,683 RHCs were analyzed for a study period of eight years: 2008 – 2015. In addition, data were analyzed for a subset of 116 RHCs located in Florida, Texas, and California that participated in a Medicare ACO in one or more years of the study period. Two broad findings resulted from this investigation. First, for both the nationwide panel of RHCs and the three-state sample of “ACO RHCs,” there was a decrease in the mean disparities in diabetes-related hospitalization rates over the eight-year study period. Second, in comparing a three-year time period after Medicare ACO implementation in 2012 to a four-year period before the implementation, a statistically significant difference in mean disparities was found for the nationwide panel. There are a number of factors that may contribute to the decrease in diabetes-related hospitalization rates for Latinos in more recent years. Future research will identify specific contributors to reducing diabetes-related hospitalization disparities between Latinos and the general population, including the possible influence of ACO participation by RHCs. This paper presents original research conducted using data related to rural Latino older adults. The data represent multiple states and an eight-year time period. The U.S. Latino population is growing at a rapid pace. As a group, they are at a high risk for developing diabetes, the complications of which are serious and costly to the patient and the U.S. healthcare system. With the continued growth of the Latino population, it is critical that their health disparities be monitored, and that factors that contribute to their health and well-being be identified and promoted.