波将金保护:评估提供者目录的准确性和及时访问在加利福尼亚州的四个专业。

IF 4.3 3区 材料科学 Q1 ENGINEERING, ELECTRICAL & ELECTRONIC ACS Applied Electronic Materials Pub Date : 2022-06-01 DOI:10.1215/03616878-9626866
Abigail Burman, Simon F Haeder
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引用次数: 3

摘要

背景:提供者目录的准确性和消费者是否能够安排及时的预约是卫生获取和结果的关键决定因素。方法:我们评估了从加州管理医疗保健部门获得的数据的准确性和及时性,包括对2018年和2019年加州所有管理医疗计划的初级保健提供者、心脏病学家、内分泌学家和胃肠病学家进行的大型、随机、有代表性的调查的回应。调查结果:59%到76%的名单或78%到88%的供应商能够核实这四个专业的供应商目录条目。我们发现,消费者能够为28%至54%的列表或44%至72%的准确列出的提供者安排紧急护理预约。对于一般护理预约,列出的提供者的百分比为35%至64%,准确列出的提供者的百分比为51%至87%。不同市场在准确性方面的差异通常很小。在及时获得医保方面,加州医保计划的表现优于其他市场。初级保健的表现始终优于所有其他专科。一般预约的及时接诊率高于紧急护理预约。结论:我们的发现提出了有关监管制度以及消费者获取和健康结果的问题。
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Potemkin Protections: Assessing Provider Directory Accuracy and Timely Access for Four Specialties in California.

Context: The accuracy of provider directories and whether consumers can schedule timely appointments are crucial determinants of health access and outcomes.

Methods: We evaluated accuracy and timely access data obtained from the California Department of Managed Health Care, consisting of responses to large, random, representative surveys of primary care providers, cardiologists, endocrinologists, and gastroenterologists for 2018 and 2019 for all managed care plans in California.

Findings: Surveys were able to verify provider directory entries for the four specialties for 59% to 76% of listings or 78% to 88% of providers reached. We found that consumers were able to schedule urgent care appointments for 28% to 54% of listings or 44% to 72% of accurately listed providers. For general care appointments, the percentages ranged from 35% to 64% of listed providers or 51% to 87% of accurately listed providers. Differences across markets related to accuracy were generally small. Medi-Cal plans outperformed other markets with regard to timely access. Primary care consistently outperformed all other specialties. Timely access rates were higher for general appointments than for urgent care appointments.

Conclusions: Our finding raise questions about the regulatory regime as well as consumer access and health outcomes.

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来源期刊
CiteScore
7.20
自引率
4.30%
发文量
567
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