在ACO中的医生报告了更大的文档负担
Nate C Apathy1, Vaishali Patel, Tricia Lee Rolle
1University of Maryland, 4200 Valley Dr, College Park, MD 20742.
The American journal of managed care
|May 31, 2024
概括
基于价值的支付 (VBP) 计划中的医生,特别是负责护理组织 (ACO),面临着增加的下班记录时间. 这种文档负担与质量报告和风险调整要求有关,不一定是放宽报销规则.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 医疗信息学 医疗信息学
- 医疗保健政策 医疗保健政策
背景情况:
- 基于价值的支付 (VBP) 模式旨在提高医疗保健质量和降低成本.
- 医生的文档负担,特别是与电子健康记录 (EHR) 相关的负担,越来越令人担忧.
- 了解VBP参与对医生工作量的影响对于成功的医疗保健改革至关重要.
研究的目的:
- 分析基于价值的支付 (VBP) 计划参与与办公室医生的文档负担之间的关系.
- 检查特定的VBP计划,如负责护理组织 (ACO),如何影响EHR文档负担.
主要方法:
- 使用国家电子健康记录调查 (2019年和2021年) 的横截面数据进行回顾性分析.
- 使用普通最小平方回归模型来评估VBP参与与EHR文档负担之间的关联.
- 进行了特定计划的分析,以区分各种VBP模型的影响.
主要成果:
- 参与任何VBP计划与每天报告超过一小时的下班记录的概率增加了10.5%.
- 负责照顾组织 (ACO) 的参与显著推动了这一总体关系,导致每天估计增加18分钟的下班记录.
- ACO参与者报告说,记录文件的难度增加,并且更有可能在不适当的文档任务上花费时间.
结论:
- 在ACO的办公室医生在多个指标上经历了更大的文档负担.
- 虽然一些ACO可能会减少退款文件,但对质量报告和风险调整的要求可能会增加整体负担.
- 多个VBP计划和支付人的累积效应可能会加剧医生的文档工作负担.
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