为什么学术医疗中心在以价值为基础的护理方面如此难以取得成功?
Bob Kocher1, Robert M Wachter2
1Department of Health Policy, Stanford University, 3340 Hillview Avenue, Palo Alto, CA 94304, United States.
Health affairs scholar
|May 17, 2024
概括
学术医疗中心 (AMC) 由于工作流程和经济限制,面临基于价值的护理方面的挑战. 适应需要降低成本和提高初级保健技能,以获得未来的成功.
科学领域:
- 医疗保健管理的管理
- 卫生经济学 卫生经济学
- 临床操作 临床操作
背景情况:
- 学术医疗中心 (AMC) 对医学教育和研究至关重要,但在不断变化的医疗支付模式中面临财务风险.
- 传统的服务费偿还结构历来支持AMC,但基于价值的护理模式带来了新的财务压力.
研究的目的:
- 确定AMC在过渡到基于价值的支付模式时所面临的关键挑战.
- 探索阻碍AMC适应成本效益高的护理服务的核心能力和系统因素.
主要方法:
- 分析可能阻碍转换的AMC的共同属性.
- 识别系统性障碍,包括电子医疗记录 (EMR) 系统,薪酬模式,组织结构,劳动力组成和会计系统.
主要成果:
- 医疗医疗中心在以价值为基础的护理方面扎,因为他们对重新设计临床工作流程和改变与提供者的经济关系的能力有限.
- 现有的EMR,基于数量的补偿,严格的组织结构,专业重型劳动力和复杂的会计阻碍了必要的变化.
结论:
- 医疗保健中心必须降低成本,并发展初级和预防性护理专业知识,以在以价值为基础的护理中取得成功.
- 另外,AMCs可以选择退出基于价值的护理,增加服务费的价格,以弥补潜在的数量下降.
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