基于人口的初级保健支付系统的实施与夏威夷的质量措施之间的关联
在PubMed上查看摘要
概括
此摘要是机器生成的。夏威夷医疗服务协会 (Hawaii Medical Service Association) 的以人口为基础的初级保健支付 (3PC) 在第一年显示质量有所提高,初级保健访问减少. 新的支付模式没有显著影响医疗保健总成本.
科学领域
- 医疗服务研究
- 医疗保健支付模式
- 提高初级保健的质量
背景情况
- 夏威夷医疗服务协会 (HMSA) 在2016年实施了一种新的基于资本的支付系统,即基于人口的初级保健支付 (3PC).
- 这一支付改革对医疗保健质量,利用率和支出的影响仍未得到评估.
研究的目的
- 评估3PC支付系统与质量措施的变化,医疗保健的利用和实施初期的成本之间的关联.
- 提供早期评估夏威夷初级保健补偿的重大转变.
主要方法
- 一个观察性研究利用HMSA声明和临床注册数据从2012年到2016年.
- 一个倾向加权的差异分析将归因于3PC参与医生的成员与服务费模型中的成员进行比较.
主要成果
- 3PC系统与综合质量测量得分的统计学上显著改善有关 (2,3个百分点高于非3PC组).
- 与非3PC组相比,3PC组的初级保健访问显著减少 (调整后的差异变化为3. 9%).
- 两组患者的护理总费用没有显著差异.
结论
- 夏威夷的3PC支付系统的初始年表现出适度的质量提升和初级保健使用率下降,但没有影响整体医疗保健支出.
- 需要进一步研究以了解这种支付模式的长期影响和通用性.
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