在医疗保健中衡量价值:从负责任的护理组织中吸取教训
Chenzhang Bao1, Indranil R Bardhan2
1Department of Management Science and Information Systems, Oklahoma State University, Tulsa, OK 74106, United States.
Health affairs scholar
|May 17, 2024
概括
由于协调挑战,负责的护理组织 (ACO) 的价值停滞不前. 提高ACO价值需要一种"规模薄,范围广"的方法,重点关注社区伙伴关系和弱势群体.
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
- 卫生政策 卫生政策
背景情况:
- 负责任的护理组织 (ACO) 旨在通过改善结果和降低成本来提高医疗保健价值.
- 尽管实施了十年,但ACO所提供的真正价值仍然不完全理解.
- 现有的措施可能无法充分捕捉医疗保健价值的多方面的性质.
研究的目的:
- 通过数据包裹分析,引入一种新的医疗保健价值衡量方法.
- 调查ACO组织特征与医疗保健价值之间的关系.
- 检查健康的社会决定因素 (SDOH) 对ACO价值的影响.
主要方法:
- 开发一种新的医疗保健价值指标,利用数据包裹分析 (DEA).
- 分析ACO结构属性 (例如,医生领导,实体数量) 与拟议的价值衡量标准之间的关联.
- 统计检查各种SDOH因素对ACO值的影响.
主要成果:
- 近年来,ACO提供的医疗保健价值呈现出停滞.
- 仅由医生领导的ACO和那些拥有更多参与实体的ACO显示出较低的价值.
- 经济稳定,健康饮食和获得医疗保健等因素显著预测了ACO价值.
结论:
- 建议ACO采用"规模薄,范围广"的战略,以提高医疗保健价值.
- 政策干预应鼓励ACO与社区合作.
- 在分散的系统中加强对弱势群体的护理协调对于ACO的成功至关重要.
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