基于医院的紧急医疗补助计划是否有利于创伤中心? 一个混合方法分析分析
Lisa Marie Knowlton1, Daniel S Logan, Katherine Arnow
1From the Section of Trauma (L.M.K.), Surgical Critical Care and Acute Care Surgery, Stanford University; Stanford-Surgery Policy Improvement Research and Education Center (L.M.K., D.S.L., K.A., W.D.H., A.B.G., L.D.T., T.H.W., A.M.M.); and Department of Surgery (L.M.K., A.M.M.), Stanford University School of Medicine, Stanford, California.
The journal of trauma and acute care surgery
|October 13, 2023
概括
医院假设资格 (HPE) 增加了医疗补助收入,并减少了医院,特别是创伤中心的无偿护理. 该计划改善了患者获得护理的机会和医院的财务稳定性.
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
- 创伤护理 创伤护理
背景情况:
- 医院假设资格 (HPE) 在住院期间提供临时的医疗补助覆盖.
- 惠普可以改善患者获得退院后资源的机会,并促进持续的医疗补助覆盖.
- HPE计划对创伤中心 (TC) 的影响仍然不太清楚.
研究的目的:
- 检查HPE参与与医院医疗补助退款之间的关联.
- 确定推动HPE在普通医院和TC中招生的激励因素.
- 假设HPE参与的财务,运营和基于任务的激励措施.
主要方法:
- 融合混合方法研究,包括对加利福尼亚州年度财务披露报告 (2005-2021) 的分析.
- 与医院利益相关者 (n=8) 进行半结构面试的专题分析,以探索HPE参与激励措施.
- 主要结果:医疗补助的净收入;次要结果:无偿护理费用.
主要成果:
- 分析的加利福尼亚州医院 (285/367) 的77.7%参与HPE,包括到2015年初100%的TC.
- 惠普的参与与医疗补助的净收入有着显著的积极关联,特别是在一级和二级的医疗补助中心.
- HPE招生与患者医疗补助收入净增长 (b=6.74,p<0.001) 和未补偿护理成本降低 (b=-2.22,p<0.05) 相对应,独立于ACA变化.
- 利益相关方的激励措施包括减少医院不良债务,提高患者满意度,改善社区获得护理的机会.
结论:
- HPE 计划是创伤患者长期保险的关键途径.
- 惠普的参与有助于创伤中心的财务可行性.
- 建议简化HPE招生流程,以减少医院负担并确保患者参与.
相关概念视频
Specialized Care Centers and Settings-II
738
Rural Health Centers
Rural health centers are specialized care facilities in remote locations with very few medical personnel. The primary care providers who run the centers are mostly Registered Nurse Practitioners. Here, emergency treatment is provided to critically ill or injured patients before they are transferred to the closest hospital. Fortunately, due to advancement in technology, many rural healthcare facilities and professionals have easy access to diagnostic and treatment...
Rural health centers are specialized care facilities in remote locations with very few medical personnel. The primary care providers who run the centers are mostly Registered Nurse Practitioners. Here, emergency treatment is provided to critically ill or injured patients before they are transferred to the closest hospital. Fortunately, due to advancement in technology, many rural healthcare facilities and professionals have easy access to diagnostic and treatment...
738
Methods of Documentation VI: Case Management Model
581
The case management model is a multidisciplinary approach that involves healthcare professionals from diverse disciplines, such as physicians, nurses, therapists, social workers, and pharmacists, working collaboratively to address the various needs of patients. Each healthcare professional brings unique expertise and perspectives, contributing to a more comprehensive understanding of the patient's condition and tailoring treatment plans accordingly.
For example, a patient with a chronic...
For example, a patient with a chronic...
581
Methods of Documentation VII: EMR
844
Electronic Medical Records (EMRs) primarily center around electronically documenting patients' health information within a single healthcare organization or practice. They contain essential clinical data related to a patient's medical history, diagnoses, medications, treatment plans, lab results, and other pertinent information relevant to the specific encounter or episode of care. EMRs are designed to streamline documentation and workflow processes within individual healthcare...
844
Standards of Care I
702
Federal statutes profoundly impact nursing practice, providing critical guidelines to ensure patient care is equitable, accessible, and of the highest quality. The following laws address distinct aspects of healthcare provision and patient rights:
702
Community Based Intervention
46
Community-based interventions in mental health represent a paradigm shift from institution-centered care to treatments embedded within the fabric of local communities. By prioritizing inclusion and leveraging existing societal structures, this approach fosters a supportive environment conducive to addressing mental health challenges while promoting individual dignity and agency.
Foundations of Community Mental Health Programs
Central to the success of community-based interventions is the...
Foundations of Community Mental Health Programs
Central to the success of community-based interventions is the...
46
Hospitals-I
859
Hospitals offer medical and surgical care to the sick and injured, along with accommodation while they recover. At the same time, they also provide outpatient, emergency, psychiatric, and rehabilitation services to meet various community needs. In addition to providing medical care, hospitals also act as hubs for medical research and training. Hospitals use clinical procedures and evidence-based practice standards to deliver patient care. To deliver safe and efficient care, a nurse must stay up...
859


