PATTERNS OF REFERRAL AND CARE FOR CHILDREN ON MEDICAID

描述：本申请建议使用补充担保 1989年至1992年六个州的收入（SSI）和医疗补助索赔数据： (1)描述护理模式;（2）检查病例关联 （3）研究供应商的影响 特点和供应;（4）研究农村/城市的影响和人口 特征，和（5）比较儿科和非儿科亚专家。 一些儿童慢性疾病将进行分析，以更好地 了解转介模式及其后果。 若干转诊 模式将被探索，包括初级保健管理，共同管理， 一次性专科会诊、专科管理。 美国 医学协会（AMA）数据文件将通过以下方式与跟踪护理相关联： 专业类型和比较，除了通常和习惯 人口统计学，成人与儿科专家提供的护理。 监测的因变量将包括利用率、成本、某些 质量指标（例如，糖尿病患者定期进行眼科检查）， 结果（例如，脊柱裂患者的尿路感染）。

Description: This application proposes to utilize Supplemental Security Income (SSI) and Medicaid claims data from 1989 to 1992 in six states to: (1) characterize patterns of care; (2) examine the association of case pattern with resource use and quality; (3) study effects of provider characteristics and supply; (4) study rural/urban effects and demographic characteristics, and (5) compare pediatric and non-pediatric subspecialists. A number of childhood chronic conditions will be analyzed to better understand referral patterns and their consequences. Several referral patterns will be explored, including primary care management, co-management, one-time subspecialty consultation, and subspecialty management. American Medical Association (AMA) data files will be linked to track care by specialty type and to compare, in addition to the usual and customary demographics, care provided by adult versus pediatric specialists. Dependent variables monitored will include utilization, costs, certain quality indicators (e.g., regular eye exams for diabetics), and some outcomes (e.g., urinary tract infections in patients with spina bifida).