کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
6239237 1278990 2015 8 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Effects of changes in copayment for obstetric emergency room visits on the utilization of obstetric emergency rooms
ترجمه فارسی عنوان
تأثیرات تغییرات در مصاحبه در اتاق اورژانس مامایی در مورد استفاده از اتاق های اورژانس مامایی
کلمات کلیدی
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی سیاست های بهداشت و سلامت عمومی
چکیده انگلیسی


- We assessed if changes in copayment contributed to Obstetrical ER (OER) overcrowding.
- Exemption from copayment for visits during non-working hours of primary care clinics was associated with increases in non-urgent OER visits.
- Younger and first-time mothers with medically unjustified complaints were more likely to be discharged to home.
- Changes in the policy for OER copayment added to the workload of medical personnel.

In view of the growing proportion of “non-urgent” admissions to obstetric emergency rooms (OERs) and recent changes in copayment policies for OER visits in Israel, we assessed factors contributing to OER overcrowding. The changes investigated were (a) exemption from copayment for women with birth contractions, (b) allowing phone referrals to the OER and (c) exemption from copayment during primary care clinic closing hours.We analyzed data of a large tertiary hospital with 37 deliveries per day. Counts of women discharged to home from the OER were an indicator of “non-urgent” visits.The annual number of non-urgent visits increased at a higher rate (3.4%) than the natural increase in deliveries (2.1%). Exemption from copayment for visits during non-working hours of primary care clinics was associated with increases in OER admissions (IRR = 1.22) and in non-urgent OER visits (IRR = 1.54). Younger and first-time mothers with medically unjustified complaints were more likely to be discharged to home.We showed that the changes in the policy for OER copayment meant to attract new clients to the HMO had an independent impact on OER utilization, and hence, added to the workload of medical personnel. The change in HMO policy regulating OER availability requires rigorous assessment of possible health system implications.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Health Policy - Volume 119, Issue 10, October 2015, Pages 1358-1365
نویسندگان
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