捆绑支付与手术条件的支出,利用和质量的关联:范围审查
Ahmad M Hider1, Amalia E Gomez-Rexrode1, Josh Agius2
1University of Michigan Medical School, Ann Arbor, MI, USA.
American journal of surgery
|December 26, 2023
概括
基于事件的捆绑支付减少了手术手术的医疗保健支出,特别是在骨科,而不会对患者的结果产生负面影响. 对非骨科手术条件需要进一步的研究.
科学领域:
- 卫生经济学 卫生经济学
- 医疗保健管理的管理
- 外科手术的结果
背景情况:
- 基于事件的捆绑支付旨在降低医疗保健成本并改善护理协调.
- 由于定义的护理时间和可变的支出,手术条件是潜在的目标.
- 捆绑支付激励医院在特定的临床情节内降低成本.
研究的目的:
- 审查有关基于病例的捆绑支付模式对医疗保健支出,利用率和外科条件质量的影响的文献.
主要方法:
- 使用四个数据库进行了范围审查.
- 搜索包括捆绑支付和手术的术语.
- 研究被独立选,以包括.
主要成果:
- 28项研究符合纳入标准;大多数专注于骨科手术.
- 捆绑支付与总体支出的减少有关,主要是由于急性护理后护理成本的降低.
- 再入院和并发症等临床结果没有受到不利影响.
结论:
- 目前的证据表明,捆绑支付可以降低骨科手术的成本,而不会影响质量.
- 有限证据表明,捆绑支付对非骨科手术条件的影响有限.
- 需要进一步研究对护理质量和获得护理的更广泛影响.
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