医疗保险基于功绩的激励支付系统中的白内障手术:基于事件的成本衡量标准的开发和评估
Suzann Pershing1,2,3, Alexander T Sandhu1,4, Aimée-Sandrine Uwilingiyimana1
1Acumen LLC, Burlingame, California.
Ophthalmology science
|June 5, 2023
概括
这项研究开发了一种新的白内障手术成本指标,该指标是在医疗保险 (Medicare) 质量支付计划 (Quality Payment Program) 下进行的. 与非选择性措施相比,基于事件的成本衡量更好地反映了临床医生的成本和质量.
科学领域:
- 眼科医生 眼科 眼科
- 卫生经济学 卫生经济学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 医疗保险质量支付计划旨在提高医疗保健的质量和价值.
- 开发准确的成本指标对于绩效评估至关重要.
研究的目的:
- 在医疗保险质量支付计划中开发和评估白内障手术的基于事件的成本指标.
- 根据非选择性成本评估来评估这项措施的性能.
主要方法:
- 基于Medicare白内障手术病例的索赔分析 (2016年6月至2017年5月).
- 从手术前60天到手术后90天的确定的发作,包括相关服务.
- 计算的事件成本,临床医生依赖的变化,以及与并发症相关的成本.
主要成果:
- 分析了超过583,000次白内障手术.
- 基于事件的测量结果显示,与非选择性测量结果 (39%) 相比,临床医生依赖的成本变化 (94%) 更高.
- 有并发症的情节造成的成本明显更高 (3738美元与2276美元相比).
结论:
- 基于事件的成本指标在反映成本分配,临床医生的影响和质量调整方面表现出卓越的表现.
- 持续的维护和改进对于该措施的临床有效性和可靠性至关重要.
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