如何将患者转移到大量医院:探索影响驱动因素
Elisabetta Listorti1, Erica Pastore2, Arianna Alfieri2
1Centre for Research on Health and Social Care Management (CERGAS), SDA Bocconi School of Management - Bocconi University, Milan, Italy. elisabetta.listorti@sdabocconi.it.
BMC health services research
|November 17, 2023
概括
患者的特征,如年龄和医院的因素,如距离,显著影响医院的选择. 了解这些驱动因素对于医疗保健集中战略至关重要,尤其是在考虑农村与城市环境时.
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
- 患者行为分析分析
背景情况:
- 医疗保健系统越来越多地使用集中政策,引导患者前往大量医院以获得更好的结果.
- 量与结果的关联强调了专门的,高活动中心的绩效好处.
- 了解患者选择驱动因素对于有效的医疗保健重组至关重要.
研究的目的:
- 分析影响患者在选择大 (大容量) 和小 (低容量) 医院之间的决策的因素.
- 确定驱动医院选择的关键患者,医院和地区特征.
- 为医疗保健政策提供最佳医院集中策略的信息.
主要方法:
- 意大利皮埃蒙特地区 (2004-2018) 结肠癌手术的分析.
- 根据国际体积标准将医院选择分类为大/小.
- 描述性统计,假设测试和物流回归模型,包括患者,最近的大医院和领土变量.
主要成果:
- 患者的个人特征 (例如年龄) 和医院属性 (例如距离) 是主要的决定因素.
- 调查结果支持大医院的整合服务,特别是当小型医院在地理上相邻时.
- 患者的并发症会影响对医院质量的反应,即使是在更远的距离.
结论:
- 将医疗保健服务集中在大量医院是改善临床绩效的长期战略.
- 了解患者选择动态对于患者选择的医疗保健系统至关重要.
- 研究结果为决策者设计有效的医院集中战略提供了可操作的见解.
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