Changes in care coordination and health insurance in the population of US children with muscular dystrophy, 2005-2006 and 2009-2010.

IF 0.8 Q4 NURSING International Journal of Care Coordination Pub Date : 2018-12-01 Epub Date: 2018-12-14 DOI:10.1177/2053434518818448
Jaimie Z Shing, Tiebin Liu, Rodolfo Valdez
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引用次数: 2

Abstract

Introduction: We aimed to assess changes in care coordination and health insurance coverage among US children with muscular dystrophy.

Methods: We used 2005-2006 and 2009-2010 data from the National Survey of Children with Special Health Care Needs. We examined the distribution of sociodemographic and health characteristics of children with muscular dystrophy by survey cycle. Multivariable regression was used to calculate odds of not receiving effective care coordination, not having adequate health insurance coverage, receiving no help coordinating care, and having problems obtaining referrals in each survey cycle.

Results: In the 2005-2006 and 2009-2010 survey cycles, there were 135 and 117 children with muscular dystrophy (representing 34,672 and 31,169 US children with muscular dystrophy), respectively. The percentage of children with muscular dystrophy who did not receive effective care coordination changed from 59.2% (95% confidence interval (CI), 45.6%-72.7%) in 2005-2006 to 53.4% (95% CI, 38.3%-68.6%) in 2009-2010. The odds of not receiving effective care coordination (adjusted odds ratio (aOR) = 0.77; 95% CI, 0.32-1.89) or having problems obtaining referrals (aOR = 0.52; 95% CI, 0.17-1.59) did not change significantly between the two periods, whereas odds of having inadequate insurance coverage decreased significantly (aOR = 0.41, 95% CI, 0.18-0.93) and odds of not receiving help coordinating care increased significantly (aOR = 4.22, 95% CI, 1.24-14.29) between the two periods.

Conclusion: Our results suggest key health care needs for many families with children with muscular dystrophy have remained unmet for a prolonged period. Although there were significant improvements in health insurance coverage, nearly one-third of children with muscular dystrophy still had inadequate health insurance coverage in 2009-2010; it is likely that this situation has not changed much since then.

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2005-2006年和2009-2010年美国肌肉萎缩症儿童人口护理协调和健康保险的变化。
我们的目的是评估美国肌肉萎缩症儿童护理协调和健康保险覆盖率的变化。方法:我们使用2005-2006年和2009-2010年全国特殊卫生保健需要儿童调查的数据。采用调查周期法对肌萎缩症患儿的社会人口分布及健康特征进行了分析。使用多变量回归来计算在每个调查周期中没有得到有效的护理协调、没有足够的健康保险覆盖、没有得到帮助协调护理和有问题获得转诊的几率。结果:在2005-2006年和2009-2010年的调查周期中,分别有135名和117名肌肉萎缩症儿童(分别代表34,672名和31,169名美国肌肉萎缩症儿童)。肌肉萎缩症患儿未接受有效护理协调的比例从2005-2006年的59.2%(95%可信区间(CI), 45.6%-72.7%)变为2009-2010年的53.4% (95% CI, 38.3%-68.6%)。未接受有效护理配合的几率(调整优势比(aOR) = 0.77;95% CI, 0.32-1.89)或难以获得转诊(aOR = 0.52;95% CI, 0.17-1.59)在两个时期之间没有显著变化,而保险覆盖面不足的几率显著降低(aOR = 0.41, 95% CI, 0.18-0.93),未得到帮助协调护理的几率显著增加(aOR = 4.22, 95% CI, 1.24-14.29)。结论:我们的研究结果表明,许多有肌肉萎缩症儿童的家庭的关键卫生保健需求在很长一段时间内仍未得到满足。尽管医疗保险覆盖面有了显著改善,但2009-2010年,近三分之一的肌肉萎缩症儿童的医疗保险覆盖面仍然不足;从那时起,这种情况很可能没有太大变化。
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来源期刊
CiteScore
3.10
自引率
14.30%
发文量
15
期刊介绍: The International Journal of Care Coordination (formerly published as the International Journal of Care Pathways) provides an international forum for the latest scientific research in care coordination. The Journal publishes peer-reviewed original articles which describe basic research to a multidisciplinary field as well as other broader approaches and strategies hypothesized to improve care coordination. The Journal offers insightful overviews and reflections on innovation, underlying issues, and thought provoking opinion pieces in related fields. Articles from multidisciplinary fields are welcomed from leading health care academics and policy-makers. Published articles types include original research, reviews, guidelines papers, book reviews, and news items.
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