需要提高质量才能跨越沟
Matthew Pirritano1, Katrina Miller Parrish2, Yonsu Kim3
1Quality Improvement, Local Initiative Health Authority, Los Angeles, California, USA mpirritano@lacare.org.
一个全面的质量改善计划在一个大型的医疗补助健康计划中显著改善了健康结果. 这种方法与绩效支付相结合,增强了医疗保健有效性数据和信息集指标.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 提高质量 提高科学 提高质量
- 卫生政策分析 卫生政策分析
背景情况:
- 与其他发达国家相比,美国医疗保健机构在护理质量方面落后.
- 美国的医疗保健支出优先考虑昂贵的治疗,而不是预防性护理.
- 医疗补助医疗保健计划为各种健康风险和健康的社会决定因素的不同人群提供服务.
研究的目的:
- 评估综合质量改进计划对健康结果的影响,而不是按绩效支付.
- 评估十年来医疗保健有效性数据和信息集 (HEDIS) 指标的变化.
- 在大量的医疗补助人口中证明综合质量改进战略的有效性.
主要方法:
- 使用回归不连续设计进行影响评估.
- 分析了来自县级医疗补助计划的10年行政医疗保健数据.
- 对比综合质量改进计划下的结果与绩效支付模式.
主要成果:
- 在实施质量改进计划后,在多个HEDIS指标中观察到显著的改善.
- 综合计划在关键绩效指标上表现出更好的影响,而不是单纯的绩效支付.
- 卫生结果显示了可衡量的积极趋势,可归因于质量改善计划.
结论:
- 全面的质量改进计划对于改善医疗补助人口的健康结果至关重要.
- 将质量改进策略与绩效支付模式相结合,为医疗保健提供提供了强有力的方法.
- 有证据支持向积极主动,全面的战略转变,以提高医疗保健的质量和效率.
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