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Issues And Trends In Healthcare Delivery System01:29

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The issues and trends in healthcare delivery are constantly changing. The COVID-19 pandemic is one recent issue that wreaked havoc on healthcare systems, causing a shortage of healthcare workers, high demand for medicines and supplies, and increased medical expenditure due to a lack of insurance. Other issues include rising healthcare costs and care fragmentation.
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The healthcare system is constantly changing and complex. Various services are available from different healthcare providers, but gaining access to these services has become challenging for people with limited healthcare insurance. Uninsured people present a challenge to healthcare because they frequently postpone or forego treatment.
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Hospitals provide inpatient and outpatient services. Inpatient services provide care to patients that stay in the hospital for an extended period, ranging from days to months. Examples of inpatient services include intensive care units, hospital wards, or surgeries. Outpatient services provide care to patients who come to a hospital for a diagnostic or treatment but do not stay overnight —for example, diagnostic tests, surgical procedures, or health education.
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相关实验视频

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Improving IV Insulin Administration in a Community Hospital
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医院自主权如何影响提供者支付改革的有效性?

Sian Hsiang-Te Tsuei1,2,3, Winnie Chi-Man Yip3

  • 1Department of Family Practice, UBC, Vancouver, British Columbia, Canada.

The International journal of health planning and management
|May 14, 2024
PubMed
概括

拥有更大的自治权的医院可能无法在提供者支付改革 (PPRs) 下提高卫生系统的效率. 对财务和设备采购的自主性与PPR反应较差,口袋支出增加有关,这表明利. 政策制定者必须在授予自治权之前考虑现有激励措施.

关键词:
中国中国中国中国.全球预算全球预算组织自主,组织自主.提供商支付改革 提供商支付改革

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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
  • 公共卫生政策 公共卫生政策

背景情况:

  • 提供者支付改革 (PPR) 旨在提高卫生系统的效率,但结果各不相同.
  • 医院的组织特点,特别是自主权,可以影响PPR实施的有效性.
  • 了解医院自主性如何与PPR相互作用,对于优化医疗保健服务至关重要.

研究的目的:

  • 调查医院更高的自主性是否会导致更有效地应对提供者支付改革.
  • 检查医院自主权不同维度对PPRs影响的温和效应.

主要方法:

  • 利用来自中国 (2014-2018) 集群随机控制PPR干预的数据.
  • 干预将退款从服务费转移到新合作医疗计划 (NCMS) 的全球预算.
  • 评估过剩,招聘和采购方面的自主性,将这些与差异差异估计器进行交互.

主要成果:

  • 对剩余和设备采购的自主性与NCMS支出增长的增加相关,表明PPR响应较差.
  • 这些自主性维度也显示出更高的自费支出趋势.
  • 拥有多余自主权的医院每次入院的自费费用更高,这表明利最大化倾向.

结论:

  • 增加医院自主性并不能保证对以效率为重点的PPRs的反应得到改善,特别是如果以前的激励措施鼓励利最大化.
  • 政策制定者需要在实施之前评估与自治相关的潜在不良激励措施.
  • 调整财政激励措施对于使医院行为与PPR目标保持一致至关重要.