为医院整合选择医生:理论考虑和经验发现
Health care management review
|February 14, 2024
概括
医院越来越多地收购医生实践,导致更高的成本而没有提高质量. 整合医生往往经验较少,质量得分较低,并治疗更复杂的患者,这表明医院的战略转变.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 医疗保健经济学 医疗保健经济学
- 医生实践管理 医生实践管理
背景情况:
- 美国医疗保健系统正在经历医院医生整合的增加.
- 这一趋势涉及医院获得更多的医生实践.
- 这种整合与医疗保健成本的增加有关,但没有显著的质量改善.
研究的目的:
- 为了确定医生过渡到医院就业的特点.
- 了解医生融入医院系统的决定因素.
主要方法:
- 使用固定效应物流回归模型.
- 分析了医生变量 (质量得分,经验,患者复杂性,实践风格,位置).
- 综合医疗保健市场和县级数据.
主要成果:
- 分析了101,746名医生;在2018年至2020年期间,整合了3,656名医生.
- 整合医生经验较少,质量得分较低,每名医疗保险患者收入较低.
- 他们的患者具有更高的并发病率,双重资格,并且居住在较贫困地区.
结论:
- 整合医生经常面临复杂患者病例和质量指标挑战的报销压力.
- 医院可能正在与经验较少,能够管理复杂患者的医生进行整合.
- 结果表明潜在的反竞争因素和医院医生整合的劳动力转移.
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