医院对基于活动的资金和价格激励的反应:来自爱尔兰的证据
Gintare Valentelyte1, Conor Keegan2, Jan Sorensen3
1Structured Population and Health services Research Education (SPHeRE) Programme, School of Population Health, RCSI University of Medicine and Health Sciences, Dublin, Ireland; Healthcare Outcome Research Centre (HORC), School of Population Health, RCSI University of Medicine and Health Sciences, Dublin, Ireland.
Health policy (Amsterdam, Netherlands)
|September 23, 2023
概括
基于活动的资助 (ABF) 和价格激励措施并没有提高爱尔兰腹腔镜胆囊切除术的医院效率. 这些医疗保健融资政策需要加强,以提高手术日病率并减少住院时间.
科学领域:
- 卫生经济学 卫生经济学
- 医疗保健政策 医疗保健政策
- 医院管理 医院管理
背景情况:
- 基于活动的资金 (ABF) 激励医院的效率.
- 价格激励可以进一步提高医疗保健的效率.
- 爱尔兰公立医院在2016年引入了ABF,并在2018年推出了腹腔镜胆囊切除术的每日病例激励措施.
研究的目的:
- 评估ABF和特定价格激励对爱尔兰医院效率的影响.
- 评估政策实施后的一日病例手术率和停留时间的变化.
- 确定爱尔兰公共医院是否响应了新的医疗保健融资机制.
主要方法:
- 利用了国家医院住院调查数据 (2013-2019).
- 采用了一种倾向性得分匹配差异差异的方法.
- 在公立医院的公共和私人患者中利用了支付变化.
主要成果:
- 没有发现ABF引入对日间病例入院或停留时间有重大影响.
- 腹腔镜胆囊切除术的价格激励也没有显著影响效率结果.
- 医院提供者没有明显地改变他们的做法,以应对资金变化.
结论:
- 爱尔兰公共医院目前的ABF和价格激励政策在提高腹腔镜胆囊切除术效率方面无效.
- 需要进一步加强这些医疗保健融资机制.
- 政策调整是必要的,以实现医院效率和手术护理提供所需的改善.
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