综合护理的财政激励:基于证据的设计的范围审查和经验教训
Dimitar Yordanov1, Anne Sophie Oxholm1, Thim Prætorius2
1Danish Centre for Health Economics, Department of Public Health, University of Southern Denmark, Campusvej 55, 5230 Odense M, Denmark.
Health policy (Amsterdam, Netherlands)
|January 30, 2024
概括
像共享储蓄这样的金融激励措施可以改善慢性疾病的综合护理. 然而,有效性各不相同,基础设施支持对于在医疗保健系统中成功实施至关重要.
科学领域:
- 医疗保健管理的管理
- 卫生经济学 卫生经济学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 医疗保健系统正在进行重组,以应对慢性疾病的增加.
- 由于缺乏财政激励,跨供应商的护理整合往往是无效的.
研究的目的:
- 确定为慢性疾病综合护理提供财政激励措施.
- 评估这些激励措施的成本效益和实施促进者/障碍者.
主要方法:
- 对来自美国和荷兰的33项研究进行了范围审查.
- 在2021年12月之前进行的文献搜索.
主要成果:
- 确定了四种激励类型:共享储蓄,捆绑支付,绩效支付和协调支付.
- 成本效益的显著差异;基础设施 (EMR,通信) 是一个关键障碍.
- 促进者包括明确的沟通,实施支持,IT,培训和指导方针.
结论:
- 所有的激励类型都可以促进综合护理,但成功取决于环境.
- 共享储蓄显示了具有更强的因果证据的经济有效整合的前景.
- 有限的证据阻碍了在不同的医疗保健环境中得出广泛的,可转移的结论.
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