利益相关者对荷兰产妇护理支付改革的看法:一项Q方法研究
Zoë T M Scheefhals1, Eline F de Vries2, Jeroen N Struijs1
1Department of National Health and Healthcare, Center for Public Health, Healthcare and Society, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands; Department of Public Health and Primary Care, Health Campus The Hague, Leiden University Medical Center, The Hague, the Netherlands.
Social science & medicine (1982)
|November 24, 2023
概括
利益相关者同意荷兰产妇护理支付改革的必要性,但在其设计和目标上存在分歧. 共同创作是提高替代支付模式普及的关键.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 医疗保健经济学 医疗经济学
- 孕产妇健康 孕产妇健康
背景情况:
- 替代支付模式 (APM) 显示了通过促进协作和优化服务使用来提高医疗保健质量的潜力.
- 荷兰面临着相对较高的围产死亡率,这使得产妇护理改革至关重要.
- 尽管2017年进行了捆绑支付实验,但APM在荷兰产妇护理中的采用仍然很低,以收费服务模式为主.
研究的目的:
- 探索有关荷兰产妇护理支付改革的不同利益相关者的观点.
- 确定阻碍该部门实施APM的障碍.
- 为有效的医疗保健支付改革提供政策制定信息.
主要方法:
- 采用Q方法研究来捕捉利益相关者的观点.
- 参与者 (护理经理,助产士,妇科医生,管理人员,保险公司) 对有关支付改革的陈述进行了排名.
- 因子分析确定了利益相关者之间不同的观点.
主要成果:
- 关于产妇护理支付改革的三个主要观点出现了.
- 一个总体的观点,专注于结果,获得了广泛的部门支持.
- 两个互补的观点分别强调了平等和合作.
结论:
- 荷兰孕产妇护理利益相关者之间就支付改革的必要性达成共识.
- 关于改革的目的,设计和条件的不同看法带来了实施挑战.
- 建议采用协作,共同创作的方法,以提高利益相关者的参与度,信任度和APM采用率.
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