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医疗补助基于价值的支付和医疗保健对精神疾病患者的使用
Ashley Lewis1, Renata E Howland1, Leora I Horwitz2
1Department of Population Health, NYU Grossman School of Medicine, New York, New York.
JAMA health forum
|September 22, 2023
概括
在纽约,纽约.
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
- 公共卫生政策 公共卫生政策
背景情况:
- 患有精神疾病的医疗补助受益人代表了一个复杂的,高度需要的人口.
- 基于价值的支付 (VBP) 改革旨在提高护理质量和效率.
- 在医疗补助计划中,VBP对这一特定人群的影响仍未得到充分研究.
研究的目的:
- 为了评估纽约州医疗补助VBP改革和医疗保健利用模式之间的关联.
- 特别关注被诊断患有严重抑郁症,双相情感障碍和/或精神分裂症的成年医疗补助受益人.
主要方法:
- 使用差异分析的回顾性队列研究.
- 在VBP实施前和之后的比较利用变化 (2013年7月至2019年6月).
- 包括18-64岁的纽约州特定心理健康诊断的医疗补助受益人.
主要成果:
- VBP改革与抑郁症和双相情感障碍患者的行为健康访问显著增加有关.
- 在所有研究的诊断组中,观察到心理健康急诊室访问的显著减少.
- 对于抑郁症/双极性障碍的初级保健访问没有显著变化;对于精神分裂症患者来说,有所减少.
结论:
- 医疗补助VBP改革与行为健康服务利用率的增加有着积极的关联.
- 改革还与心理健康相关的急诊室访问量大幅减少有关.
- VBP可能是一种有效的策略,可以改善精神疾病的医疗补助患者的医疗保健利用率.
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