开发和实施马里兰州计划,提供医院支付激励措施,以减少再接收差异
Kyle Rice1, Alyson Schuster2, Allan Pack2
1Department of Mental Health, Johns Hopkins Bloomberg School of Public Health.
Medical care
|June 8, 2023
概括
这项研究引入了第一个美国全州政策,为医院提供财政激励,以减少再接收差异. 该计划成功激励了45家医院中的26家医院,以改善其在减少患者再入院差异方面的表现.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 卫生政策 卫生政策
- 健康差异 在健康上的差异
背景情况:
- 社会决定因素显著影响医院再入院率.
- 解决这些差异对于公平的医疗保健服务至关重要.
- 现有的政策没有充分激励医院减少弱势群体的再入院.
研究的目的:
- 开发和评估一项新的计划,鼓励医院减少再接收差异.
- 通过使用标准化的方法来衡量再入院的医院级差异.
- 奖励那些在减少再接收差异方面取得改善的医院.
主要方法:
- 一项观察性研究利用来自45家急症医院的住院患者索赔数据.
- 用一个多层模型来评估社会因素 (种族,医疗补助覆盖率,地区贫困指数) 与再接收风险之间的关联.
- 主要衡量标准是随着时间的推移,医院级再录取差异的百分比变化.
主要成果:
- 2019年,在45家医院中,有26家医院在减少再接收差异方面表现改善.
- 该计划成功地创建了一个与减少差距相关的金融激励结构.
- 该方法允许测量医院内部的差异.
结论:
- 该倡议是美国首次大规模努力将医院支付与减少健康差距联系起来.
- 基于索赔数据的方法可适应在其他州使用,并用于测量其他健康结果的差异.
- 激励医院内部的差异解决了人们对为高需要人群服务的医院处罚的担忧.
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