改善复杂环境中的绩效:荷兰两家医院战略的混合方法评估
Erik Wackers1, Simone van Dulmen1, Bart Berden1
1Radboud University Medical Center, Radboud Institute for Health Sciences, IQ healthcare, Nijmegen, The Netherlands.
International journal of health policy and management
|August 14, 2023
概括
医院的策略可以提高护理质量和降低成本,但需要大量的成本降低努力,以实现财务可持续性. 成功实施涉及协调和医生财务安全,而成本控制不足带来风险.
科学领域:
- 医疗保健管理的管理
- 医疗保健服务研究 医疗服务研究
- 提高质量 提高质量
背景情况:
- 医院正在实施战略,以提高护理质量和降低成本.
- 这些双重目标战略在现实世界中的有效性尚未得到充分理解.
- 2014年,荷兰两家医院采用了以质量为导向的战略.
研究的目的:
- 评估以质量为导向的医院战略的背景,机制和结果.
- 评估这些医疗保健计划的实际有效性.
- 提供对金融可持续性和潜在风险的见解.
主要方法:
- 混合方法评价结合了定性和定量数据.
- 与62个不同的医疗保健利益相关者进行半结构化采访.
- 分析财务报表,国家质量指标,患者报告的经验和战略文件.
主要成果:
- 这些策略导致护理量减少,但不影响质量.
- 一家医院正在努力削减成本,这影响了利率.
- 关键机制包括质量项目,改善协调,数据使用,设施扩展,共享储蓄和医生财务安全.
结论:
- 整个机构的战略将重点从生产转移到护理质量.
- 长期的财务可持续性需要大幅降低固定成本.
- 如果成本没有降低或付款人对付失去了,战略会带来财务风险.
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