替代支付模式和患者报告的出院准备质量:一项追溯纵向研究
Sunny C Lin1, Julia Adler-Milstein2, John M Hollingsworth3
1Department of Medicine, Washington University in St. Louis, St Louis, MO, USA.
Journal of patient experience
|March 25, 2024
概括
替代支付模式 (APM) 没有改善患者为医院后护理做好准备,尽管改进的准备减少了医院再入院. 医院可能需要更多地投资患者参与策略,以改善护理过渡.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 医疗保健政策 医疗保健政策
- 患者的治疗结果.
背景情况:
- 患者为医院后护理做好准备对于减少医院再入院至关重要.
- 替代支付模式 (APM) 通过将支付与患者结果联系起来,鼓励医院降低再接收率.
- APM对患者出院准备的影响尚不清楚.
研究的目的:
- 为了确定患者报告的医院后护理准备程度是否与重新入院减少相关.
- 调查参与APM是否与患者更好地准备出院有关.
主要方法:
- 利用了来自美国2685家医院 (2013-2017) 的回顾性观察数据.
- 使用3项护理过渡措施测量患者准备.
- 通过医院比较评估了30天的所有原因风险调整的再入院.
- 从医疗保险,AHA调查和Leavitt Partners收集了APM参与数据.
主要成果:
- APM与改善患者为医院后护理做好准备没有显著的关联.
- 改善患者为医院后护理做好准备与重新入院的减少有关 (边际效应: -0.012个百分点).
- 调查结果表明,在APM下,医院对患者参与的投资可能不足.
结论:
- 目前的APM似乎没有促进更好的患者出院准备.
- 改善患者参与护理过渡对于减少再入院至关重要.
- 需要进一步的研究来探索各种医院环境中的因果关系和概括性.
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