优先考虑俄勒冈州的医院资源. 一个基于自由裁量医疗利用的变化的一个例子
E S Fisher1, H G Welch, J E Wennberg
1Center for the Evaluative Clinical Sciences, Dartmouth Medical School, Hanover, NH 03755-3862.
JAMA
|April 8, 1992
概括
这项研究建议优先考虑医院资源,根据当地容量进行自由裁量医疗入院,为俄勒冈州提供替代方案.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 医疗保健经济学 医疗保健经济学
- 公共卫生政策 公共卫生政策
背景情况:
- 俄勒冈州的医疗保健配给方法专注于特定的治疗方法.
- 医疗保健中存在替代资源分配策略的需要.
研究的目的:
- 提出基于当地医院资源的医疗保健优先级模型,用于自由裁量医疗入院.
- 评估这种基于资源的方法的潜在成本节约.
主要方法:
- 对1988年俄勒冈州医院离院数据的分析,用于自由裁量医疗入院.
- 根据医院服务区域计算年龄和性别调整的人均住院治疗日数.
- 通过根据当前使用情况设定上限利率来确定潜在的节约.
主要成果:
- 在俄勒冈州的医院服务区域,自由裁量医疗入院率差异很大.
- 潜在的年度节约从400万美元到947万美元不等.
- 使用塞勒姆的税率作为上限,可以节省大约4730万美元,并关闭238张床位.
结论:
- 医院资源分配给高使用地区的自由裁量入院提供了重新分配的重要来源.
- 限制医疗保健供应单位 (病床,设备,医生) 是重新分配资源的可行选择.
- 这种模式提供了一个治疗特定配给的替代方案.
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