更全面地衡量医生和医院之间的垂直整合
Qian Eric Luo1, Bernard Black2, David J Magid3
1Milken Institute School of Public Health, George Washington University, Washington, DC, USA.
Health services research
|May 1, 2024
概括
一项新的测量准确地跟踪医生与医院的整合,显示雇佣医生的数量大幅增加. 这种工具对于了解医疗保健质量和支出影响至关重要.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 卫生经济学 卫生经济学
- 医疗保健管理的管理
背景情况:
- 医生与医院的整合,定义为医生在医院或卫生系统的就业,是一个日益增长的趋势.
- 精确测量这种整合对于评估其对医疗保健质量和支出的影响至关重要.
- 现有的医生医院整合措施在准确性和可重复性方面存在局限性.
研究的目的:
- 开发一种新的,准确的,可重复的衡量医生和医院之间垂直整合的方法.
- 使用此措施来评估整合对医疗保健质量和支出的影响.
- 改进用于研究目的的综合医生的识别.
主要方法:
- 开发了一个使用来自多个数据源 (IRS,CMS) 的税务识别号码 (TIN) 的新整合措施.
- 基于通过医院相关的TIN进行首要或独家计费的定义医生整合.
- 评估了所有从1999年到2019年收取医疗保险费用的医生的整合状态.
- 将新措施与现有方法进行比较,并进行模拟研究.
主要成果:
- 确定了12269个与医院相关的TIN,由546,775名医生使用.
- 估计医生与医院的整合率从1999年的19%增加到2019年的43%.
- 新的措施确定了与更简单的基于TIN或服务位置的措施相比,医生实践的综合性要大得多.
- 强调了研究中准确的医生整合识别的重要性.
结论:
- 已经开发出了一种新的,可重复的医生与医院整合的措施.
- 这项措施识别了比以前可能的更多的综合医生实践.
- 这些发现强调了在医疗保健研究中需要精确的整合指标.
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