计费改革对学术医院医师和高级实践提供者合作的影响:定性研究
Sara Westergaard1, Kasey Bowden2, Gopi J Astik3
1Division of Hospital Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA.
Journal of hospital medicine
|April 10, 2024
概括
对于共享医生和高级实践提供者 (APP) 访问的医疗保险计费改革提议可能会对合作和专业满意度产生负面影响. 目前的员工配置模式正在由于短缺和财务压力而发展,而不是以团队为基础的护理.
科学领域:
- 医疗保健管理的管理
- 医疗人员 医疗人员
- 卫生政策 卫生政策
背景情况:
- 医疗保险正在实施医生和高级实践提供者 (APP) 分享的住院访问的新收费改革.
- 改革建议,花费患者访问时间最多的临床医生将支付患者访问费用.
- 这一变化影响了医院环境中的护理协调和报销方式.
研究的目的:
- 调查医院医疗团队如何在患者护理中使用APP.
- 评估拟议的医疗保险计费政策对未来APP使用的潜在影响.
- 了解医生和APP对这些变化的看法.
主要方法:
- 进行了六个焦点小组,包括来自21家学术医院的医院医生,APP和领导人.
- 采用快速定性方法进行分析,包括混合的诱导和演方法.
- 用模板摘要和矩阵分析对33名参与者进行语义层面的数据分析.
主要成果:
- 使用APP的员工模式正在迅速发展,由短缺,财务因素和治理驱动.
- 提出的基于时间的计费被认为是优先考虑任务而不是认知工作量.
- 人们担心,计费变化可能会对协作和临床医生满意度产生负面影响.
结论:
- 医生和APP的合作模式正在转向独立的访问,受工作量,财务和法规的影响.
- 目前的员工配置模式是由外部因素驱动的,而不是最佳的团队动态.
- 计费政策应由对患者,临床医生和组织结果的最佳人员配置模式的研究提供信息.
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