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医院熟练护理设施的整合和参与捆绑支付计划
Jason D Buxbaum1,2, François de Brantes3,4, David C Grabowski1
1Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts.
医院熟练护理设施 (SNF) 整合显示,与参与医疗保险护理改进先进计划 (BPCI-A) 捆绑付款的参与相关性下降,特别是在主要关节置换病例中. 其他因素也可能影响自愿支付改革参与.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 医疗保健经济学 医疗保健经济学
- 以价值为基础的护理
背景情况:
- 减少机构急症后护理与节省替代支付模式有关.
- 如果收入受到威胁,组织可能会犹是否加入志愿者计划.
研究的目的:
- 检查医院熟练护理机构 (SNF) 整合和参与医疗保险的护理改进先进计划 (BPCI-A) 捆绑支付之间的关系.
主要方法:
- 从2018年开始对医院参与BPCI-A的横截面分析.
- 根据15个变量,将SNF集成的医院与非集成的同行匹配.
- 物流模型根据整合和其他因素估计了参与率.
主要成果:
- 整合与参与下肢主要关节置换 (MJRLE) 事件的参与率下降了4.7个百分点.
- 对于部和大腿骨,败血症或中风发作,整合和参与之间没有发现显著的关联.
- 在各个发作中,SNF的整合程度各不相同,从11.8%到16.5%的符合条件的医院.
结论:
- 医院-SNF整合和BPCI-A参与之间的关联在不同的护理情节中是不一致的.
- 除了整合之外的因素在决定参与自愿支付改革倡议时可能更为关键.
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