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首页> 外文期刊>Pediatrics: Official Publication of the American Academy of Pediatrics >Health care utilization by adolescents on medicaid: implications for delivering vaccines.
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Health care utilization by adolescents on medicaid: implications for delivering vaccines.

机译：青少年对药物的卫生保健利用：运送疫苗的意义。

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OBJECTIVE: To examine the degree to which current health care utilization patterns of Medicaid-enrolled adolescents living in Michigan would allow opportunities for adolescent immunizations to be provided. METHODS: Outpatient claims data from 2001-2005 were analyzed for 11- to 18-year-old Medicaid-enrolled adolescents living in Michigan. Visits were classified as either health-maintenance examinations (HMEs) or problem focused by using diagnostic and procedural codes. Data were divided into 4 overlapping 2-year time periods, and the age-specific proportion of adolescents who attended these 2 visit types was calculated for each. chi(2) tests were used to evaluate associations of visit patterns with gender. RESULTS: Of the 718847 adolescents included in the study, <50% had >or=1 HME visit within any 2-year time period, and substantially fewer (<15%) had annual HMEs. In contrast, at least 75% of the adolescents had >or=1 problem-focused visit in any given 2-year period, and approximately half had participated in at least 2 problem-focused visits. Problem-focused, but not HME, visit utilization was significantly associated with gender, with girls increasing, but boys decreasing, visit utilization as they aged. CONCLUSIONS: Similar to privately insured adolescents, most Medicaid-enrolled adolescents do not have annual preventive-care visits, which calls into question the feasibility of providing immunizations primarily at annual HMEs. Participation in problem-focused encounters was generally high in our study. However, even problem-focused visit utilization was low among older adolescent boys. This suggests that in addition to strengthening immunization within the medical home, alternative venues for reaching certain subpopulations of adolescents should also be developed.
机译：目的：研究居住在密歇根州的经医疗补助登记的青少年当前的医疗保健利用方式将为青少年提供免疫接种的机会的程度。方法：分析了2001年至2005年居住在密歇根州的11至18岁医疗补助青少年的门诊索赔数据。通过使用诊断和程序代码，将访问分为健康维护检查（HME）或针对问题的分类。将数据分为4个重叠的2年时间段，并分别计算了参加这2次就诊类型的青少年的特定年龄比例。 chi（2）检验用于评估访问方式与性别的关联。结果：在研究中包括的718847名青少年中，<50％的HME访视在两年内≥1次，或者<= 15％，并且每年HME的人数要少得多（<15％）。相比之下，在任何给定的两年时间内，至少有75％的青少年进行了以问题为中心的探访，或≥1，并且大约一半的青少年参加了至少2次以问题为中心的探访。以问题为中心而不是HME的访问利用率与性别显着相关，随着年龄的增长，女孩的访问利用率有所提高，而男孩的访问利用率却有所下降。结论：与私人参保的青少年相似，大多数参加医疗补助计划的青少年都没有年度预防保健访问，这使人们怀疑主要在年度HME进行免疫的可行性。在我们的研究中，以问题为中心的遭遇的参与率普遍很高。但是，即使是针对问题的探访利用率，在大龄男孩中也很低。这表明，除了在医疗之家加强免疫外，还应开发其他途径来接触某些青少年人群。

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