三种常见的选择性手术的医疗保健模式:捆绑支付模式的影响
Nicholas L Berlin1, Neil Kamdar2, John Syrjamaki3
1Section of Plastic Surgery, University of Michigan, Ann Arbor, Michigan.
The Journal of surgical research
|July 30, 2023
概括
对于常见的选择性手术,如乳房缩小和神经减压,医疗保健服务的使用情况有很大差异. 建议将捆绑支付模式定制为特定程序,以获得更好的基于价值的护理.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 外科手术的结果
- 卫生经济学 卫生经济学
背景情况:
- 捆绑支付模式旨在通过包括一个程序的所有服务来改善基于价值的护理.
- 目前的捆绑付款计划不包括许多常见的选择性手术.
- 了解手术前和手术后的医疗保健利用率对于设计有效的支付模式至关重要.
研究的目的:
- 评估三个常见的可选外科手术程序的医疗保健服务利用时间,持续时间和性质.
- 为这些程序设计基于情节的捆绑支付计划提供信息.
主要方法:
- 使用私人保险公司国家索赔数据库 (2010-2017年) 进行回顾性队列研究.
- 包括经过乳房缩小,上肢神经减压和泛尼切除术的患者.
- 通过中断时间序列分析,分析了手术前后12个月的医疗保健索赔.
主要成果:
- 在三个手术过程中,观察到医疗保健服务利用模式的显著差异.
- 术前利用率逐渐增加,在手术前7-9个月达到顶峰,主要是诊断和门诊服务.
- 术后利用率呈现逐渐下降,使用急性后护理服务有限,持续时间不同 (3-6个月).
结论:
- 选择性外科手术程序表现出不同的医疗保健利用情况.
- 捆绑支付模式应根据个别外科手术的具体时间和使用时间进行调整.
- 这种方法可以优化基于价值的护理手术目前不包括捆绑付款.
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