We all take more frugal measures during economic uncertainty and decline. Less spending on clipping coupons, entertainment and meals, or your favorite brand name General It will not harm you. But sometimes there is a length to go to save money.
When you are sick, some Give up your doctor’s visit I am in favor of the remedy that can be purchased without a cheap prescription. Others distribute expensive prescriptions insulin To make the supply last.
Delaying health care is with costs. with short Already vulnerable. For young and healthy adults, it may not be very dangerous to release the expired medical promise. However, for those who are old or suffering from chronic diseases Performing treatment Otherwise, the risk of preventing diseases or complications will increase.
Our health and health care is not immunity to economic change, but research has been limited to how the changes in economic assistants affect. quality Treatment.
Recent study
In the published study medical treatmentThe evaluators of the partner’s evidence -based policy resource center explored the relationship between the local economy and the quality of treatment by investigating the risk of prevention of hospitalization or death among the elderly who had diabetes treated by the Veterans Health Department (VHA).
The authors followed the cohort of more than 468,000 VHA patients over 65 years of age who were diagnosed with diabetes from July 1, 2012 to June 30, 2014. The baseline data was captured a year before diabetes diagnosis, and Cohort’s veterans were at least 24 months.
Using medical research and quality prevention quality indicators, researchers have confirmed four interests. This included diabetes (short -term complications, long -term complications, hospitalization, unhearded diabetes hospitalization), and three types of preventive hospitals related to death.
The authors have confirmed six market variables, characterized by the scope and abundance of health insurance. Health insurance variables included VHA registration ratios over 65 years old, Medicare Advantage market penetration rate, and health insurance coverage for men aged 18-64. The regional rich variables included the middle of the household import, the housing price index and the veteran unemployment rate.
The evaluator used a two -stage individual COX proportional risk model to evaluate the relationship between the treatment quality of the VHA primary care service and the economic situation.
result
This study has found that most local market variables are related to hospitalization or death that can be prevented. More health insurance coverage was associated with low utilization of VHA treatment and low risk of preventing hospitalization or death. Similarly, the higher the household income and the higher the housing price index, the lower the risk of prevention of hospitalization and death. But the author did not find the influence of veteran unemployment.
Using survival analysis, the authors predict that the increase in the level of primary care workers in the VHA can reduce the risk of prevention of prevention of hospitalization or death by diabetes in an average VHA facility. However, if the VHA facility is affected by the economic downturn, the beneficial reduction can be partially offset.
conclusion
The author acknowledged some limitations. As a VHA analysis, the results are not common to all patients or health systems. As an observation study, there may be an unexplained confusion effect that affects the validity of the results. The evaluator also showed that it was difficult to use administrative data to identify diabetes diagnosis due to the difference in diagnosis and the method of the method coded in the electronic health records.
The results of this study support the need for understanding of how to build elasticity so that health systems, especially safety net providers can withstand challenging economic conditions. The authors suggested that the VHA can benefit by coordinating the changes in local economic conditions and assigning national resources accordingly. They argued that the hospital, which was repaid as a non -VHA safety net hospital, especially the value -based payment model, could be unfairly punished for the treatment quality caused by the deterioration of the economic situation and ultimately worsening quality problems.
There may be quality health care Maximum It is important if time becomes difficult. Therefore, the health system should use all available tools to receive the highest quality treatment that can be the most influenced by the economic downturn.
PEPREC is a team of health economists, public health researchers and policy analysts who support VA efforts to improve the lives of Veterans by using advanced quantum methods that are mostly funded by QUERI in the Veterans Health Bureau.
