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Insurance Status and Quality of Diabetes Care in Community Health Centers

机译:社区卫生中心的糖尿病保险状况和护理质量

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摘要

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.
机译:目标。我们试图比较由联邦政府资助的社区卫生中心按保险类型划分的糖尿病护理质量。我们将2002年从17个州的27个社区卫生中心中随机选择的2018年糖尿病患者分为6个互斥保险组。根据6个全国质量保证健康计划委员会雇主数据和信息集,我们使用多元Logistic回归分析比较了糖尿病护理的质量,并设置了糖尿病护理过程和结果指标。 33%的患者没有医疗保险,24%的患者仅享受Medicare,15%的患者仅享受Medicaid,7%的患者拥有Medicare和Medicaid,14%的患者拥有私人保险,7%的患者拥有另一种保险类型。那些没有保险的人最不可能达到医疗质量标准;拥有Medicaid的人的医疗质量与没有保险的人类似。结论。需要进行研究,以通过社区卫生中心等安全网提供者之间的保险地位来确定护理质量差异的主要中介者。此类研究对于医疗补助计划设计中的政策干预以及提高护理质量的激励措施是必要的。

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