从医疗补助过渡到商业保险后糖尿病足溃疡患者的治疗效果。

IF 2.4 Q3 ENDOCRINOLOGY & METABOLISM
Diabetology Pub Date : 2024-08-01 Epub Date: 2024-08-21 DOI:10.3390/diabetology5030027
KiBeom Kwon, Taylor A Brown, Juan C Arias Aristizábal, David G Armstrong, Tze-Woei Tan
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引用次数: 0

摘要

目的:本研究调查了患有糖尿病足溃疡(DFU)的医疗补助受益人在过渡到商业保险后的治疗效果:本研究调查了糖尿病足溃疡(DFU)医疗补助受益人转为商业保险后的治疗效果:我们利用 PearlDiver 索偿数据库来识别 2010 年至 2019 年期间诊断出新的 DFU 的成年患者。研究队列包括 8856 名医疗补助受益人,他们在确诊 DFU 后至少连续参保三年。不包括在随访期间转入医疗保险的医疗补助受益人。通过按 1:1 的比例对两组患者的年龄、性别和 Charlson 生病指数 (CCI) 进行倾向匹配,对结果进行调整比较。我们使用逻辑回归和 Kaplan-Meier 估计来评估保险变更(从医疗补助转为商业保险)与大截肢之间的关系:在 8856 名患有 DFU 的医疗补助受益人中,66%(n = 5809)在随访期间转为商业保险。总体大截肢率为 2.8%(n = 247),与持续享受医疗补助的患者相比,转为商业保险的患者大截肢率较低(2.6% vs. 3.2%,p < 0.05)。在多变量分析中,过渡到商业保险的医疗补助受益人发生大截肢的风险比持续享受医疗补助的受益人低 27%(研究队列:几率比 [OR] 0.75,95% CI 0.56-0.97,p = 0.03;匹配队列:OR 0.65,95% 0.22,0.55,p = 0.01):结论:在患有 DFU 的医疗补助受益人中,从医疗补助过渡到商业保险可能与较低的大截肢风险有关。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Outcomes for Patients with Diabetic Foot Ulcers Following Transition from Medicaid to Commercial Insurance.

Objective: This study investigates the outcomes of Medicaid beneficiaries with diabetic foot ulcers (DFUs) who had transitioned to commercial insurance.

Methods: We utilized the PearlDiver claims database to identify adult patients diagnosed with a new DFU between 2010 and 2019. The study cohort comprised 8856 Medicaid beneficiaries who had at least three years of continuous enrollment after DFU diagnosis. Medicaid beneficiaries who transitioned to Medicare during follow-up were excluded. Adjusted comparisons of outcomes were performed by propensity matching the two groups for age, gender, and Charlson Comorbidity Index (CCI) in a 1:1 ratio. We used logistic regression and Kaplan-Meier estimate to evaluate the association between insurance change (from Medicaid to commercial insurance) and major amputation.

Results: Among the 8856 Medicaid beneficiaries with DFUs, 66% (n = 5809) had transitioned to commercial insurance coverage during follow-up. The overall major amputation rate was 2.8% (n = 247), with a lower rate observed in patients who transitioned to commercial insurance compared to those with continuous Medicaid coverage (2.6% vs. 3.2%, p < 0.05). In multivariable analysis, Medicaid beneficiaries who transitioned to commercial insurance had a 27% lower risk of major amputation (study cohort: odds ratios [OR] 0.75, 95% CI 0.56-0.97, p = 0.03; matched cohort: OR 0.65, 95% 0.22, 0.55, p = 0.01) compared to those with continuous Medicaid coverage.

Conclusions: Transitioning from Medicaid to commercial insurance may be associated with a lower risk of major amputation among Medicaid beneficiaries with DFUs.

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