PDF(Pubmed)
Abstract：
BACKGROUND: Self-harm presents an important public health challenge. It imposes a notable burden on the utilization of emergency department (ED) services and medical expenses from patients and family. The Medicaid system is vital in providing financial support for individuals who struggle with medical expenses. This study explored the association of Medicaid coverage with ED visits following incidents of self-harm, utilizing nationwide ED surveillance data in Korea.
METHODS: Data of all patients older than 14 years who presented to EDs following incidents of self-harm irrespective of intention to end their life, including cases of self-poisoning, were gathered from the National ED Information System (NEDIS). The annual self-harm visit rate (SHVR) per 100,000 people was calculated for each province and a generalized linear model analysis was conducted, with SHVR as a dependent variable and factors related to Medicaid coverage as independent variables.
RESULTS: A 1% increase in Medicaid enrollment rate was linked to a significant decrease of 14% in SHVR. Each additional 1,000 Korean Won of Medicaid spending per enrollee was correlated with a 1% reduction in SHVR. However, an increase in Medicaid visits per enrollee and an extension of Medicaid coverage days were associated with an increase in SHVR. SHVR exhibited a stronger associated with parameters of Medicaid coverage in adolescents and young adults than in older adult population.
CONCLUSIONS: Expansion of Medicaid coverage coupled with careful monitoring of shifts in Medicaid utilization patterns can mitigate ED overloading by reducing visits related to self-harm.
METHODS: Data of all patients older than 14 years who presented to EDs following incidents of self-harm irrespective of intention to end their life, including cases of self-poisoning, were gathered from the National ED Information System (NEDIS). The annual self-harm visit rate (SHVR) per 100,000 people was calculated for each province and a generalized linear model analysis was conducted, with SHVR as a dependent variable and factors related to Medicaid coverage as independent variables.
RESULTS: A 1% increase in Medicaid enrollment rate was linked to a significant decrease of 14% in SHVR. Each additional 1,000 Korean Won of Medicaid spending per enrollee was correlated with a 1% reduction in SHVR. However, an increase in Medicaid visits per enrollee and an extension of Medicaid coverage days were associated with an increase in SHVR. SHVR exhibited a stronger associated with parameters of Medicaid coverage in adolescents and young adults than in older adult population.
CONCLUSIONS: Expansion of Medicaid coverage coupled with careful monitoring of shifts in Medicaid utilization patterns can mitigate ED overloading by reducing visits related to self-harm.
摘要：
背景：自我伤害是一项重要的公共卫生挑战。它对急诊科（ED）服务的使用以及患者和家人的医疗费用造成了显着负担。医疗补助系统对于为与医疗费用作斗争的个人提供财务支持至关重要。这项研究探讨了医疗补助覆盖与自我伤害事件后急诊就诊的关系，利用韩国全国的ED监测数据。
方法：所有年龄在14岁以上的患者的数据，这些患者在发生自残事件后出现在ED中，而不管是否打算结束生命，包括自我中毒的病例,是从国家ED信息系统(NEDIS)收集的。计算了各省每10万人的年度自残访视率(SHVR),并进行了广义线性模型分析,以SHVR为因变量，与医疗补助覆盖率相关的因素为自变量。
结果：医疗补助入学率增加1％与SHVR显着下降14％有关。每增加1,000韩元的医疗补助支出与SHVR减少1％相关。然而,每位参保人的Medicaid访视次数的增加和Medicaid承保天数的延长与SHVR的增加相关.与老年人群相比，SHVR与青少年和年轻人的医疗补助覆盖率参数具有更强的相关性。
结论：扩大医疗补助覆盖范围，并仔细监测医疗补助利用模式的变化，可以通过减少与自我伤害相关的就诊来减轻ED过载。
方法：所有年龄在14岁以上的患者的数据，这些患者在发生自残事件后出现在ED中，而不管是否打算结束生命，包括自我中毒的病例,是从国家ED信息系统(NEDIS)收集的。计算了各省每10万人的年度自残访视率(SHVR),并进行了广义线性模型分析,以SHVR为因变量，与医疗补助覆盖率相关的因素为自变量。
结果：医疗补助入学率增加1％与SHVR显着下降14％有关。每增加1,000韩元的医疗补助支出与SHVR减少1％相关。然而,每位参保人的Medicaid访视次数的增加和Medicaid承保天数的延长与SHVR的增加相关.与老年人群相比，SHVR与青少年和年轻人的医疗补助覆盖率参数具有更强的相关性。
结论：扩大医疗补助覆盖范围，并仔细监测医疗补助利用模式的变化，可以通过减少与自我伤害相关的就诊来减轻ED过载。
