宾夕法尼亚农村健康模型对潜在的可避免利用的早期影响
Donald S Bourne1, Eric T Roberts2, Lindsay M Sabik1
1Department of Health Policy and Management, University of Pittsburgh School of Public Health, Pittsburgh, PA 15261, United States.
Health affairs scholar
|February 5, 2024
概括
宾夕法尼亚农村卫生模型 (PARHM) 并没有显著减少农村地区可能可避免的住院病例. 影响因医院类型以及他们加入替代支付模式的时间而异.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 农村卫生政策 农村卫生政策
- 医疗保健经济学 医疗保健经济学
背景情况:
- 宾夕法尼亚农村卫生模式 (PARHM) 是一个创新的替代支付模式,专为农村医院设计.
- 它利用全球预算和交付转型计划来改善农村医疗保健的质量和结果.
- 18家医院从2019年到2021年参加了PARHM的三个队伍.
研究的目的:
- 评估PARHM对农村社区潜在可避免利用率 (PAU) 的影响.
- 确定替代支付模式是否导致医院入院率的降低,以改善目标.
- 分析不同医院队列和类型的异质效应.
主要方法:
- 使用差异差异分析.
- 利用了宾夕法尼亚州2016年至2022年的全付费医院出院数据.
- 对PARHM参与的农村社区与类似的非参与社区的PAU率进行比较.
主要成果:
- 在实施后的四年内,没有观察到社区一级PAU率的显著整体降低.
- 根据进入年份,在不同PARHM队列中确定了异质的治疗效应.
- 在关键接入医院和未来支付系统医院之间也注意到了影响的差异.
结论:
- PARHM没有证明可能可以避免的住院治疗的总体显著下降.
- 该研究强调,根据农村卫生环境中的特定背景因素,替代支付模式可能会产生不同的影响.
- 未来的替代支付模式扩展应该考虑这些对农村卫生系统的异质影响.
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