实践模型 跨州和地区医疗保险支付的趋势
Ruby L Hoyem1, Lorraine Jordan2, Valentina V Lukyanova3
1was a Research Associate at the American Association of Nurse Anesthesiology, Rosemont, Illinois.
AANA journal
|October 3, 2023
概括
麻醉治疗模式越来越倾向于认证注册护士麻醉师 (CRNA). 然而,CRNA领导的护理团队与独立CRNA实践的采用情况因州而异,即使考虑到劳动力和实践法规的范围.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 麻醉学 麻醉学
- 卫生政策 卫生政策
背景情况:
- 麻醉治疗模式受劳动力,法规,经济和组织偏好的影响.
- 国家医疗保险数据显示,面向认证注册护士麻醉师 (CRNA) 导向的麻醉输送模型的趋势.
- 由于影响因素的区域差异,这种转变可能在各州之间不均.
研究的目的:
- 分析如何提供者劳动力组成和CRNA实践范围 (SOP) 规定影响麻醉输送模型的使用.
- 检查这些因素对仅麻醉师,护理团队和非定向CRNA模型的影响.
主要方法:
- 对2010-2019年医疗保险B部分数据的分析.
- 提供者劳动力组成的统计调整和CRNA实践范围的规定.
主要成果:
- 医疗保险B部分下的麻醉输送模型显示了2010-2019年期间的显著CRNA方向.
- 护理团队与非定向CRNA模型的采用在各州非常不均和不一致.
- 即使在调整了劳动力和SOP后,这些变化仍然存在.
结论:
- 虽然在麻醉中使用CRNA的数量正在增加,但具体采用的模型因州而异.
- 除了劳动力和实践范围之外的因素,例如组织规范,可能会导致一些地区持续使用效率较低的模型.
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