Does Identification of Previously Undiagnosed Conditions Change Care‐Seeking Behavior?
研究利用REGARDS数据和Medicare索赔记录，分析家庭评估中发现未诊断的高胆固醇、高血压或糖尿病后，老年人就医行为的变化。结果显示，评估后两年内半年度就诊率提高22个百分点，但无常规医疗提供者的群体效果较低。
OBJECTIVE: To determine whether identification of previously undiagnosed high cholesterol, hypertension, and/or diabetes during an in-home assessment impacts care seeking among Medicare beneficiaries. DATA SOURCES/STUDY SETTING: Data from the REasons for Geographic And Racial Differences in Stroke (REGARDS) study, which recruited African American and white participants across the continental United States from 2003-2007, were linked to Medicare claims. STUDY DESIGN: We used panel data models to analyze changes in doctor visits for evaluation and management of conditions after participants were assessed, utilizing the study's rolling recruitment to control for secular trends. DATA EXTRACTION METHODS: We extracted Medicare claims for the 24 months before through 24 months after assessment via REGARDS for 5,884 participants. PRINCIPAL FINDINGS: Semi-annual doctor visits for previously undiagnosed conditions increased by 22 percentage points (95 percent confidence interval: 16-28) 2 years following assessment. The effect was similar by gender, race, region, and Medicaid, but it may have been lower among participants who lacked a usual health care provider. CONCLUSIONS: In-home assessment of cholesterol, blood pressure, and blood glucose can increase doctor visits for individuals with previously undiagnosed conditions. However, biomarker assessment may have more limited impact among individuals with low access to care.