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Medicaid managed care and family planning services: An analysis of recipient utilization and choice of type of provider.

机译：医疗补助管理的照料和计划生育服务：对接受者利用情况和提供者类型选择的分析。

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摘要

The Medicaid program is the largest source of public funding for family planning programs, providing half of all public dollars spent on contraceptive supplies and services. The implementation of Medicaid managed care programs has changed the delivery system. This research contributes to our understanding of this issue by analyzing the experiences of Medicaid recipients in Baltimore, Maryland who receive family planning services in a mandatory Medicaid managed care system. Qualitative data were collected from Medicaid recipients at clinic and non-clinic locations and analyzed using Atlas ti software. An analysis of providers shows no increase of private physicians new to serving the Medicaid population through the managed care program; recipients are heavily dependent on the safety net providers who have traditionally served the Medicaid population. Data indicate that the majority of recipients, 68%, seek family planning services from their usual source of care for several reasons: to maintain continuity of care, location, the ability to get appointments quickly, recommendations from family and friends, and services offered. For the 17% of recipients who chose other than their usual source of care, reasons included: not being able to get a timely appointment at their usual source of care, confidentiality, staff, and services provided. The managed care system works well for women who are enrolled in regular Medicaid and routinely seek care at clinics where there is an focus on reproductive health. Knowledge of the Family Planning Exemption, which allows recipients to seek contraceptive care from any qualified provider, was poor at all clinic sites; 65% of recipients did not know about the Exemption. This lack of knowledge was problematic and created access barriers for recipients who attempted to seek care outside of their primary clinic. Recipients who transitioned off of regular Medicaid coverage and were eligible for the Family Planning Expansion waiver program reported barriers to enrollment in this program. While rates of having ever discontinued a contraceptive method were similar at all sites, the non-clinic sites or clinic sites not focusing on reproductive health had a much higher proportion of recipients who were not contracepting and exposed to an unintended pregnancy.
机译：医疗补助计划是计划生育计划的最大公共资金来源，提供了用于避孕用品和服务的所有公共资金的一半。医疗补助管理式护理计划的实施改变了分娩系统。这项研究通过分析马里兰州巴尔的摩市的医疗补助接受者的经历，帮助他们了解这一问题，这些人在强制性医疗补助管理式护理系统中接受计划生育服务。从诊所和非诊所地点的医疗补助接受者收集定性数据，并使用Atlas ti软件进行分析。对提供者的分析显示，通过管理式护理计划服务于医疗补助人群的私人医生数量没有增加；接受者在很大程度上取决于传统上为医疗补助人口服务的安全网提供者。数据表明，大多数接收者（68％）从其通常的护理来源寻求计划生育服务，其原因有几个：维持护理的连续性，位置，快速预约的能力，家人和朋友的推荐以及所提供的服务。对于选择非常规护理来源的17％的接收者，原因包括：无法及时获得常规护理，保密性，人员和所提供服务的任命。管理式护理制度对那些参加常规医疗补助并定期在以生殖健康为重点的诊所寻求护理的妇女而言效果很好。计划生育豁免的知识使接受者可以从任何合格的服务提供者那里寻求避孕护理，但在所有诊所中都缺乏知识。 65％的接收者不知道豁免。这种知识的缺乏是有问题的，并且为试图在其主要诊所之外寻求护理的接受者造成了进入障碍。转换为常规医疗补助覆盖范围并符合计划生育扩展豁免计划资格的收件人报告了该计划的入学障碍。尽管在所有场所中止避孕方法的比率都相似，但非诊所场所或不关注生殖健康的诊所场所中，未避孕且未曾怀孕的接受者比例更高。

著录项

  • 作者

    Amey, Annette Lynn.;

  • 作者单位

    The Johns Hopkins University.;

  • 授予单位 The Johns Hopkins University.;
  • 学科 Health Sciences Health Care Management.; Health Sciences Public Health.
  • 学位 Ph.D.
  • 年度 2003
  • 页码 269 p.
  • 总页数 269
  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类 预防医学、卫生学;预防医学、卫生学;
  • 关键词

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