医院特征与观察到的转导管大动脉替换价格相关
Roni Ochakovski1, Yuqi Zhang2,3,4, Marcelo Cerullo2
1Duke University Trinity School of Arts and Sciences, Durham, North Carolina.
medRxiv : the preprint server for health sciences
|June 3, 2024
概括
超导管大动脉置换 (TAVR) 的价格差异很大,但较高的价格与更好的医院财务表现或美国新闻和世界报道排名无关. 增加的观察到预期的TAVR价格比率与医院内部价格波动减少相关.
科学领域:
- 卫生经济学 卫生经济学
- 心血管外科心血管外科
- 医疗保健管理的管理
背景情况:
- 过导管大动脉置换 (TAVR) 是大动脉狭窄的关键治疗方法.
- 在TAVR程序中存在显著的价格差异.
- 导致TAVR价格差异的因素尚不清楚.
研究的目的:
- 分析与医院财务业绩相关的TAVR价格变化.
- 调查TAVR价格与美国新闻和世界报道 (USNWR) 排名之间的关联.
- 检查观察到预期的 (O:E) TAVR价格比率如何与医院的财务指标和价格变化有关.
主要方法:
- 在640个USNWR排名的TAVR执行医院的数据上使用了修改后的两部分模型.
- 检查了财务和运营数据,包括TAVR绩效得分,TAVR中位数价格,利率和医院附加值.
- 在这些五分位数中计算了O:E TAVR价格比率和分析了医院特征.
主要成果:
- 48.6%的医院可提供价格披露.
- 具有较高O:E TAVR价格比率的医院没有表现出更高的利率或增值.
- 与最低的五分位数相比,O:E比率最高的五分位数的TAVR中位数价格显著降低,医院内价格变化减少.
结论:
- 比预期收取更多TAVR费用的医院不一定排名更高或利更高.
- 较高的观察到预期的TAVR价格比率与医院内TAVR价格变化减少有关.
- O:E TAVR的价格比率似乎与公开报告的医院质量指标没有相关性.
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