家庭透析使用和脏移植的绩效支付激励措施
Kalli G Koukounas1, Daeho Kim1, Rachel E Patzer2,3
1Department of Health Services, Policy and Practice, Brown University School of Public Health, Providence, Rhode Island.
JAMA health forum
|June 30, 2024
概括
末期病治疗选择 (ETC) 模型在最初两年没有增加家庭透析或移植的使用. 它也没有改变基于种族,种族或社会经济地位的这些结果的差异.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 医疗保健服务研究 医疗服务研究
- 卫生经济学 卫生经济学
背景情况:
- 强制性的末期病治疗选择 (ETC) 模型旨在提高家庭透析和移植率.
- 引入了金融激励措施,以鼓励美国透析设施和临床医生采用这些治疗方法.
研究的目的:
- 评估ETC模型在最初两年对家庭透析和移植利用的影响.
- 检查ETC模型是否影响了不同种族,种族和社会经济群体在这些结果中的差异.
主要方法:
- 一项回顾性,横截面研究分析了2017-2022年的医疗保险索赔和入学数据.
- 来自美国器官共享网络的移植数据被链接在一起.
- 一种差异差异 (DiD) 方法比较了ETC分配区域与控制区域的结果.
主要成果:
- 没有观察到家庭透析使用的统计显著增加 (调整后的DiD: -0.2pp).
- 没有发现移植率的显著变化 (调整后的DiD:0.02pp).
- 根据社会人口统计学因素,ETC模型并没有改变家庭透析使用的差异.
结论:
- 在ETC模型的前两年,没有与增加家庭透析或移植使用的相关性.
- 该模型没有导致这些功能衰竭治疗的种族,种族或社会经济差异发生显著变化.
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