医生退出在初级保健中的影响:对实践移交的研究
Linn Hjalmarsson1, Boris Kaiser2, Tamara Bischof3
1Department of Economics, University of Bern, Schanzeneckstrasse 1, 3001, Bern, Switzerland.
Health policy (Amsterdam, Netherlands)
|July 12, 2023
概括
一般医生 (GP) 的切换暂时增加了由于重新评估的患者访问和成本. 长期,专科护理和门诊费用上升,受实践风格变化的影响,突出了保持患者获得护理的必要性.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 卫生经济学 卫生经济学
- 一般实践一般实践
背景情况:
- 一般医生 (GPs) 显著影响医疗保健利用率和成本.
- 在GP过渡期间驱动这些影响的具体机制尚不清楚.
研究的目的:
- 量化全科医生 (GP) 切换对患者医疗保健利用和成本的短期和长期影响.
- 区分影响与人际连续性,练习风格和访问变化.
主要方法:
- 使用的瑞士初级保健实践交付数据 (2007-2015).
- 构建了与保险索赔相关的约24万名患者的面板数据集.
- 使用差异差异框架来分析影响.
主要成果:
- 观察到暂时增加的总体访问和成本,归因于新的全科医生对初始患者的重新评估.
- 发现专业护理利用率和门诊费用持续增加.
- 鉴定了实践风格差异,通常与年轻的,女性继任者全科医生有关,作为长期成本增加的驱动因素.
结论:
- 全科医生转型导致短期利用率增加,长期转向专业护理和更高的门诊费用.
- 与实践关闭不同,GP开关似乎不会减少整体利用率.
- 卫生政策应侧重于确保GP退出期间的持续患者访问,以减轻潜在的负面后果.
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