使用资源利用率带分析索赔数据,绘制儿科成像成本的支出映射
Danika Baskar1, Jamie A Jarmul2, Lane F Donnelly3
1Department of Radiology, University of North Carolina School of Medicine, Chapel Hill, NC, USA.
Current problems in diagnostic radiology
|July 24, 2024
概括
使用索赔数据绘制儿科成像成本图表显示,根据患者的复杂性,支出存在显著差异. 这种分析有助于识别高成本条件,并优化资源利用,以减少成本的举措.
科学领域:
- 卫生经济学 卫生经济学
- 儿科医疗保健分析
- 医疗成像利用利用方法
背景情况:
- 了解儿科成像开支对于医疗保健成本管理至关重要.
- 索赔数据为分析医疗保健支出模式提供了宝贵的资源.
- 资源利用带 (RUB) 为分层患者复杂性提供了一个框架.
研究的目的:
- 为了创建儿科成像成本的"支出地图".
- 将成像支出按资源利用带 (RUB) 和基本条件进行分离.
- 分析儿童群体成像成本的分布.
主要方法:
- 分析了针对儿科成员的基于商业价值的计划中的索赔数据.
- 根据发病率,成员被分为六个资源利用频段 (RUB).
- 每年每个会员 (PMPY) 的费用,成像总支出和顶级成像模式被评估为每卢布.
- 评估了与高成像成本相关的诊断类别.
主要成果:
- 在40022名儿科成员中,有14%的儿科成员在成像成本上支付了大约280万美元.
- 中等发病率 (3卢布) 的成像总成本最高 (1.159.523美元).
- 根据RUB,成像模式的花费有所不同,在较低的RUB中占主导地位的是放射学,在较高的RUB中占主导地位的是MRI.
- 总成像成本的首要诊断包括发育障碍,喘和先天性心脏病.
结论:
- 使用索赔数据进行费用映射,提高了对儿科成像成本分布的理解.
- 这种方法有助于规划降低成本的举措.
- 它提供了关于成像利用如何与患者复杂性相关的见解.
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