早期与捆绑支付的经验,以改善主要肠道手术的护理
Udai S Sibia1, John R Klune2, Said Saiolghalam3
1Providence Health System, Saint John's Cancer Institute, Santa Monica, CA, USA.
The American surgeon
|March 25, 2024
概括
大型肠道手术的捆绑支付模式显示了可变成本,急性护理设施是主要的驱动因素. 医生参与和急性后护理是提高这些捆绑支付计划效率和质量的关键.
科学领域:
- 卫生经济学 卫生经济学
- 外科手术的结果
- 医疗保健支付模式 医疗保健支付模式
背景情况:
- 捆绑支付 (BP) 模式在外科护理中越来越多地被采用.
- 本研究检查了大肠外科手术的护理改善捆绑支付 (BPCI) 的早期经验.
研究的目的:
- 在捆绑支付模式下分析大肠外科手术的成本驱动因素和结果.
- 将BP模型中的成本与传统的服务费 (FFS) 支付模式进行比较.
主要方法:
- 对202名接受大肠外科手术的患者的回顾性分析 (2021年1月至10月).
- 使用医疗保险重症诊断相关组 (MS-DRG) 代码识别患者.
- 在BP模型中分析成本组件,并与FFS进行比较.
主要成果:
- 在BP模型中,每次临床事件的平均成本为28,340美元,超过目标价格的38%.
- 急性护理设施成本 (59%) 是主要的成本驱动因素,其次是医生服务 (17%).
- 机器人手术与35%的成本增加有关;90天再入院率为17%.
结论:
- 大型肠道手术患者代表了一个异质的群体,影响捆绑支付的成功.
- 在BP模型中,医生领导对于提供高价值,以患者为中心的护理至关重要.
- 优化后急性护理设置对于提高捆绑支付计划的效率和质量至关重要.
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