在医疗补助机构内部和医疗补助机构之间的实践场所异质性
Zachary Dyer1, Matthew Alcusky1, Jay Himmelstein1
1Department of Population and Quantitative Health Sciences, UMass Chan Medical School, Worcester, MA 01655, USA.
Healthcare (Basel, Switzerland)
|January 26, 2024
概括
负责任的护理组织 (ACO) 显示出显著的内部变化. ACO内部的实践场所,而不仅仅是它们之间的实践场所,展示了医疗改革倡议的多样化经验和能力.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 医疗保健政策 医疗保健政策
- 组织研究 组织研究
背景情况:
- 现有的研究往往将负责任的护理组织 (ACO) 视为单一的实体.
- 这忽略了ACO内部个别实践场所的特征和经验的关键差异.
- 了解实践层面的异质性对于有效的医疗改革至关重要.
研究的目的:
- 在医疗补助ACO内部和之间,在实践场地层面描述经验,能力和流程的异质性.
- 分析流程变化的变化,先前的替代支付模式经验和高质量的护理提供能力.
- 通过考虑实践场所的特点,为未来的研究和计划设计提供信息.
主要方法:
- 通过2019年对马萨诸塞州Medicaid ACO实践站点225名管理人员的调查进行的观察性横截面研究.
- 在17个Medicaid ACO中按实践地点进行量化响应集群.
- 采用多级物流模型,计算中位数赔率 (MOR) 和类内相关系数 (ICC) 来评估变化.
主要成果:
- 在所有测量变量中, *在* ACOs 内的异质性比 *在* ACOs 之间的异质性更大.
- 类内相关系数 (ICC) 始终低 (≤0.26),表明实践场所的差异很大.
- 无论实践地点或ACO特征如何,这些发现都是正确的.
结论:
- 医疗补助ACO在实践现场经验和实施医疗保健计划的能力方面表现出相当大的多样性.
- 未来的问责护理组织研究和政策设计必须明确考虑组成实践场所的异质性.
- 在ACO中根据个别实践场所的需求量身定制干预措施,可以提高改革的成功率.
相关概念视频
01:29Documentation in Long-Term and Home Healthcare Setting
892
Documentation in long-term care facilities and home healthcare settings is crucial for ensuring continuous, coordinated, and comprehensive care for patients. Each setting has its specific documentation processes and tools:
Long-Term Care Facilities
Long-Term Care Facilities
892
01:22Standards of Care I
695
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:
695
01:15Methods of Documentation VI: Case Management Model
573
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...
573
01:29Issues And Trends In Healthcare Delivery System
5.6K
The issues and trends in healthcare delivery are constantly changing. The COVID-19 pandemic is one recent issue that wreaked havoc on healthcare systems, causing a shortage of healthcare workers, high demand for medicines and supplies, and increased medical expenditure due to a lack of insurance. Other issues include rising healthcare costs and care fragmentation.
Cost Containment
Payment for healthcare services has historically promoted adoption of costly and often unnecessary or inefficient...
Cost Containment
Payment for healthcare services has historically promoted adoption of costly and often unnecessary or inefficient...
5.6K
01:30Health Information Technology and Healthcare Information System
841
Health Information Technology (HIT)
Health Information Technology, commonly called HIT, integrates advanced information systems and technology in healthcare settings. Its primary functions include:
Health Information Technology, commonly called HIT, integrates advanced information systems and technology in healthcare settings. Its primary functions include:
841
01:18Healthcare Agencies I
729
Healthcare agencies provide healthcare services to people. In the United States, voluntary agencies are often non-profit centers sponsored by donations, grants, or fundraisers. One such organization is Meals on Wheels, which provides meals to the elderly and homebound. The American Heart Association and the American Lung Association are other non-profit community organizations. Doctors and nurses are frequently active members of these organizations, which offer health checks and educational...
729