考虑健康经济学,编码和补偿在整形,假肢和小孩牙科
M J Highsmith1,2, C M Fantini2, D G Smith3,4
1School of Physical Therapy & Rehabilitation Sciences, Morsani College of Medicine, University of South Florida, Tampa, Florida, USA.
Canadian prosthetics & orthotics journal
|August 24, 2023
概括
美国医疗保健系统正在转向基于价值的补偿. 这篇文章探讨了基于产品的骨架,假肢和儿牙 (O&P) 编码,并呼吁评估基于服务的替代系统.
科学领域:
- 医疗保健经济学 医疗保健经济学
- 医疗器械报销 医疗器械报销
- 专业编码系统 专业编码系统
背景情况:
- 美国医疗保健补偿正在从收费服务转向以价值为基础的模式.
- 对于许多临床医生来说,当前的程序术语 (CPT) 代码是这一转变的核心.
- 整形,假肢和形 (O&P) 专业使用一种独特的编码系统.
研究的目的:
- 为提供当前O&P编码系统的概述.
- 将O&P编码置于更广泛的医疗保健转向基于价值的报销的背景.
- 促使学术界考虑替代的O&P编码和报销模式.
主要方法:
- 编辑审查现有的O&P编码实践.
- 对O&P代码与其他医疗保健专业代码的比较分析.
- 讨论O&P代码的基于产品的与基于服务的性质.
主要成果:
- O&P代码主要以产品为基础,专注于设备特征和功能.
- 这与其他医疗保健学科形成鲜明对比,这些学科越来越多地使用基于服务的代码.
- 当前的O&P系统可能不完全符合基于价值的护理原则.
结论:
- 目前O&P专业的基于产品的编码系统需要严格的学术审查.
- 应该探索基于服务的替代编码系统,以与基于价值的报销趋势保持一致.
- 在O&P编码的战略转变可以提高该行业在基于价值的医疗保健中的作用.
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