余额计费的定义,实践,规定和影响:一个范围审查
Shaheda Viriyathorn1, Woranan Witthayapipopsakul1, Anond Kulthanmanusorn1
1International Health Policy Program (IHPP), Ministry of Public Health, Nonthaburi, Thailand.
Health services insights
|June 16, 2023
概括
额外的计费实践,如余额计费,是常见的,但不太了解. 本综述强调了它们的各种定义,对全民健康覆盖的负面影响,以及政府政策干预的必要性.
科学领域:
- 卫生经济学 卫生经济学
- 卫生政策 卫生政策
- 公共卫生 公共卫生
背景情况:
- 额外计费,也称为余额计费,是许多国家对有医疗保险的患者的普遍做法.
- 对这些额外的计费实践的了解仍然有限,需要对现有证据进行全面审查.
研究的目的:
- 审查关于额外计费实践的证据,包括其定义,范围,规定和对保险患者的影响.
- 综合关于不同医疗保健系统中额外计费的术语,范围和影响的发现.
主要方法:
- 在Scopus,MEDLINE,EMBASE和Web of Science系统搜索详细介绍医疗保健服务余额计费的全文论文 (2000-2021年).
- 对94项选定的研究进行了专题分析,至少有两名审查员进行了独立选.
主要成果:
- 大多数研究 (83%) 集中在美国,揭示了不同的术语 (余额计费,意外计费,额外计费) 和不同的服务 (急诊,手术,专家咨询) 受到影响.
- 虽然注意到了一些积极的影响,但大多数研究报告了负面影响,包括经济困难和减少获得护理的机会,破坏了全民健康覆盖 (UHC) 的目标.
- 政府已采取措施减轻不利影响,但挑战仍然存在.
结论:
- 额外的计费实践在全球范围内表现出术语,定义,范围,法规和结果的显著差异.
- 有政策干预措施来控制保险患者的大量账单,但局限性和挑战仍然存在.
- 政府必须实施多方面的政策措施,以加强对保险人群的金融风险保护.
相关概念视频
01:30Health Information Technology and Healthcare Information System
878
Health Information Technology (HIT)
Health Information Technology, commonly called HIT, integrates advanced information systems and technology in healthcare settings. Its primary functions include:
Health Information Technology, commonly called HIT, integrates advanced information systems and technology in healthcare settings. Its primary functions include:
878
01:23Methods of Documentation V: CBE
933
Charting by Exception, or CBE, is a method of documentation used in healthcare, particularly in nursing, that focuses on documenting only significant or abnormal findings rather than recording every detail. This approach aims to streamline the documentation process, improve efficiency, and ensure that healthcare providers can quickly identify deviations from normalcy in patient assessments.
In CBE, healthcare professionals establish predefined standards of practice that define what constitutes...
In CBE, healthcare professionals establish predefined standards of practice that define what constitutes...
933
01:22Standards of Care I
731
Federal statutes profoundly impact nursing practice, providing critical guidelines to ensure patient care is equitable, accessible, and of the highest quality. The following laws address distinct aspects of healthcare provision and patient rights:
731
01:15Methods of Documentation VI: Case Management Model
600
The case management model is a multidisciplinary approach that involves healthcare professionals from diverse disciplines, such as physicians, nurses, therapists, social workers, and pharmacists, working collaboratively to address the various needs of patients. Each healthcare professional brings unique expertise and perspectives, contributing to a more comprehensive understanding of the patient's condition and tailoring treatment plans accordingly.
For example, a patient with a chronic...
For example, a patient with a chronic...
600
01:29Disorders of Acid-Base Balance
250
The human body maintains a precise pH range of arterial blood between 7.35 and 7.45. Deviations result in either acidosis (pH < 7.35) or alkalosis (pH > 7.45). These conditions are further classified as respiratory or metabolic disorders based on their underlying cause.
Respiratory Acidosis and Alkalosis
Respiratory acidosis occurs due to an increase in the partial pressure of carbon dioxide PCO2 in the blood. It often arises from shallow breathing or impaired gas exchange caused by...
Respiratory Acidosis and Alkalosis
Respiratory acidosis occurs due to an increase in the partial pressure of carbon dioxide PCO2 in the blood. It often arises from shallow breathing or impaired gas exchange caused by...
250
01:29Issues And Trends In Healthcare Delivery System
5.7K
The issues and trends in healthcare delivery are constantly changing. The COVID-19 pandemic is one recent issue that wreaked havoc on healthcare systems, causing a shortage of healthcare workers, high demand for medicines and supplies, and increased medical expenditure due to a lack of insurance. Other issues include rising healthcare costs and care fragmentation.
Cost Containment
Payment for healthcare services has historically promoted adoption of costly and often unnecessary or inefficient...
Cost Containment
Payment for healthcare services has historically promoted adoption of costly and often unnecessary or inefficient...
5.7K