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.
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。