美国医疗瘤学家实践巩固,2015-2022年
Michael Milligan1,2,3, Parsa Erfani4, E John Orav4,5
1Harvard Radiation Oncology Program, Boston, MA.
JCO oncology practice
|February 26, 2024
概括
医学瘤实践在2015-2022年期间得到了显著的巩固,出现的实践较少,规模较大. 尽管有这种趋势,医疗瘤学家 (MO) 的地理分布仍然稳定,这对癌症护理的获取和成本有影响.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 瘤学实践管理的管理
- 医疗保健经济学 医疗经济学
背景情况:
- 医疗保健整合影响了癌症护理的提供.
- 在过去的二十年中,瘤实践经历了显著的整合.
- 了解这些趋势对于保持优质的癌症护理至关重要.
研究的目的:
- 调查医疗瘤学家 (MO) 之间的实践整合趋势.
- 确定与MO实践整合相关的因素.
- 分析MO地理分布的变化.
主要方法:
- 使用了2015-2022年的医疗保险数据.
- 在医院转诊区域 (HRR) 使用Herfindahl-Hirschman指数 (HHI) 评估了MO实践的整合.
- 通过基尼系数检查了各县的MO分布,并使用多变量线性回归来确定相关因素.
主要成果:
- 机关组织的数量增加了14.5%,而实践减少了18.0%,导致平均实践规模更大 (4.26至5.95机关组织/实践).
- 中位数HHI增加了9%,表明MO实践的整合更大.
- 较高的基线医院整合和人均更多的医院床位与MO实践整合相关;县级MO分布保持稳定.
结论:
- 2015年医疗瘤实践高度集中,到2022年进一步巩固.
- 虽然MO在县级的地理分布稳定,但整合对癌症治疗成本,质量和获取的影响需要进一步调查.
- 这些发现对政策制定者和支付者在设计高质量,负担得起的癌症护理计划方面有重大影响.
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