医疗保险年度健康检查的采用和价值:混合方法研究。

IF 2.4 3区 医学 Q2 HEALTH CARE SCIENCES & SERVICES Medical Care Research and Review Pub Date : 2023-08-01 Epub Date: 2023-04-26 DOI:10.1177/10775587231166037
Mika K Hamer, Matthew DeCamp, Cathy J Bradley, Donald E Nease, Marcelo C Perraillon
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引用次数: 0

摘要

医疗保险的年度健康访视(AWV)于 2011 年推出,旨在鼓励人们利用预防性服务,但许多临床医生和患者仍未参与该访视。我们利用访谈和 2012 年至 2019 年的医疗保险报销单,从初级保健的角度对年度健康访视的动机、临床和财务价值进行了定性和定量评估。病情最严重患者的初级医疗机构的 AWV 使用率比病情最轻患者的初级医疗机构低 11.2 个百分点;农村地区的使用率低 3.8 个百分点。患者的需求和经济激励是采用的动力。全病程志愿服务弥补了预防性护理方面的不足,加强了患者与医疗服务提供者之间的关系,促进了预先护理计划的制定,并为改善质量指标提供了机会。总体而言,尽管并非所有诊所都有经济动机采用这种就诊方式,这也可能是就诊率存在差异的部分原因,但 AWV 有可能提高高价值预防服务的使用率。
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Adoption and Value of the Medicare Annual Wellness Visit: A Mixed-Methods Study.

Medicare's Annual Wellness Visit (AWV) was introduced in 2011 to encourage the utilization of preventive services, but many clinicians and patients still do not participate in the visit. We qualitatively and quantitatively assessed motivations and clinical and financial value of AWVs from a primary care perspective using interviews and Medicare claims from 2012 to 2019. Primary care providers with the highest acuity patients had AWV utilization rates 11.2 percentage points lower than providers with the lowest acuity patients; utilization rates were 3.8 percentage points lower in rural counties. Adoption was motivated by patient needs and financial incentives. AWVs closed gaps in preventive care, strengthened patient-provider relationships, facilitated advance care planning, and provided an opportunity to improve quality metrics. Overall, the AWV has the potential to increase the use of high-value preventive services although not all clinics have an economic incentive to adopt the visit, which may explain some of the variability in utilization rates.

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来源期刊
Medical Care Research and Review
Medical Care Research and Review 医学-卫生保健
CiteScore
6.00
自引率
4.00%
发文量
36
审稿时长
>12 weeks
期刊介绍: Medical Care Research and Review (MCRR) is a peer-reviewed bi-monthly journal containing critical reviews of literature on organizational structure, economics, and the financing of health and medical care systems. MCRR also includes original empirical and theoretical research and trends to enable policy makers to make informed decisions, as well as to identify health care trends. This journal is a member of the Committee on Publication Ethics (COPE). Average time from submission to first decision: 25 days
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