医院医生和医院后急性护理垂直整合后的成本,质量和利用:系统性审查
Alexandra Harris1, Sarah Philbin1, Brady Post2
1Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
Medical care research and review : MCRR
|May 6, 2024
概括
美国医疗保健的垂直整合,特别是医院医生整合,与更高的成本有关,但对质量和利用的影响不确定. 医院-急性后护理整合效应仍然模糊.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 医疗保健经济学 医疗保健经济学
- 卫生政策 卫生政策
背景情况:
- 垂直整合,即卫生系统通常拥有多样化的服务,在美国正在上升.
- 这一趋势涉及医院医生和医院急性后护理 (PAC) 的整合.
- 了解这些整合对医疗保健成本,质量和利用的影响至关重要.
研究的目的:
- 系统地审查最近关于两种垂直整合和医疗保健结果之间的关联的证据.
- 检查医院医生融合及其影响.
- 评估医院-急性护理后的整合,包括医院-熟练护理机构 (SNF) 的联系.
主要方法:
- 科学文献的系统审查.
- 分析了43项关于医院医生融合的研究.
- 分析了10项关于医院-急性护理后整合的研究.
主要成果:
- 医院医生融合与医疗保健成本的增加有关.
- 医院医生整合对服务质量和利用率的影响目前尚不清楚.
- 医院-PAC集成对成本,质量和利用产生了模两可的影响,尤其是在医院-SNF联系方面.
结论:
- 政策制定者应该关注医院医生融合的增加,这可能会影响负担得起的,高质量的医疗保健.
- 医院-PAC整合对医疗保健负担能力和质量的影响不太清楚,需要进一步调查.
- 需要进一步的研究来澄清不同垂直整合模式对医疗保健系统的微妙影响.
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