医生变化和支付模式在心脏成像中的影响
Amity E Quinn1,2, Derek S Chew1,3,2, Peter Faris2,4
1Department of Medicine, Cumming School of Medicine University of Calgary Alberta Canada.
Journal of the American Heart Association
|December 12, 2023
概括
医生支付模式对心脏病患者的心脏成像使用有重大影响. 报销服务费用,特别是翻译费用,导致与雇佣模型相比,更多的成像测试.
科学领域:
- 心脏病学 心脏病学
- 医疗保健服务研究 医疗服务研究
- 卫生经济学 卫生经济学
背景情况:
- 与其他支付模式相比,费用服务报销对心脏成像的影响仍未得到审查.
- 了解心脏成像订购实践的变化是有限的.
研究的目的:
- 为了比较费用偿还与其他支付模式对心脏成像利用的影响.
- 量化心脏成像使用的变化,并确定促成因素.
主要方法:
- 以人口为基础的回顾性队列研究,使用加拿大阿尔伯塔省 (2012年4月至2018年12月) 的相关行政数据.
- 包括患有慢性心脏病 (心房动,冠状动脉疾病,心力衰竭) 咨询心脏专家的成年人.
- 一般化的线性混合效应模型分析了医生支付模型与心脏成像使用之间的关联,控制了患者,医生和位置因素.
主要成果:
- 咨询服务费医生的患者接受心脏成像的可能性是2.07倍.
- 有口译计费能力的收费服务医生表现出更高的比率 (2.87倍).
- 患者,医生和部位因素解释了31%的成像变化,分别减少了40%和29%的无法解释的部位和医生级变化.
结论:
- 在门诊心脏成像使用方面存在很大差异,受医生和地点特征的影响.
- 医生支付模式与成像利用有着显著的关联,引发了对潜在实践影响的担忧.
- 该方法可用于调查其他医疗保健过程和结果的变化.
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