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一个包括移植在内的基于价值的脏护理支付模式
Benjamin E Hippen1, George M Hart2, Franklin W Maddux1
1Global Medical Office, Fresenius Medical Care, Waltham, Massachusetts, USA.
Kidney international reports
|June 20, 2024
概括
提出了一种新的包括移植在内的基于价值的护理 (TIVBC) 模式,以改善晚期慢性病 (CKD) 和末期病 (ESKD) 患者的护理,重点是移植结果.
科学领域:
- 卫生经济学 卫生经济学
- 腎臟病學 (nephrology) 是一種醫學.
- 医疗保健政策 医疗保健政策
背景情况:
- 基于价值的护理 (VBC) 模型在美国越来越多地被采用用于脏护理,旨在提高质量和降低成本.
- 目前用于病的VBC模型将持续到2026年,因此需要对综合护理的未来规划.
- 需要更有效地将移植纳入VBC框架.
研究的目的:
- 为患有晚期慢性病 (CKD) 和末期病 (ESKD) 的患者提出一种新的包括移植在内的基于价值的护理 (TIVBC) 模式.
- 概述移植途径关键阶段的基于风险的补偿结构.
- 应对挑战,并建议未来实施端到端TIVBC模型的方向.
主要方法:
- 拟议的TIVBC模型是以一个护理期的方法来构建的.
- 基于风险的补偿是为不同的阶段设计的:转诊/评估/等待名单 (REW),移植后立即住院 (0-180天),以及长期的移植存活.
- 讨论包括器官采购成本和质量指标调整等挑战.
主要成果:
- 拟议的TIVBC模型为将脏移植纳入基于价值的补偿提供了一个框架.
- 确定模型开发所需的风险调整和成本预测的关键领域.
- 强调了潜在的挑战和需要进一步研究和改进的领域.
结论:
- 拟议的TIVBC模型为当前的脏VBC模型提供了一个补充方法.
- 成功实施需要解决器官采购成本和完善质量指标.
- 进一步发展风险调整和成本预测对于全面的TIVBC模型至关重要.
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