补充和整合医学 - 解决瑞士DRG系统下的额外工作减少报酬的情况
Fabian Grass1, Chantal Berna2, Charles-André Vogel3
1Department of Visceral Surgery, Lausanne University Hospital CHUV, University of Lausanne (UNIL), Lausanne, Switzerland.
Heliyon
|August 19, 2024
概括
对于住院患者的补充和整合医学 (CIM) 服务被瑞士DRG补偿系统所低估. 这种低估值威胁到患者的护理,尽管CIM.
科学领域:
- 卫生经济学 卫生经济学
- 综合医学是一个整体的医学.
- 医疗保健政策 医疗保健政策
背景情况:
- 补充和整合医学 (CIM) 越来越多地被认为是患者护理的价值,特别是复杂的疾病.
- 然而,很少有瑞士的第三级护理机构提供住院CIM服务.
- 当前的报销系统可能无法充分反映用于CIM的资源.
研究的目的:
- 评估瑞士诊断相关集团 (DRG) 退款系统中CIM服务的估值.
- 评估将CIM服务纳入DRG系统的财务影响.
- 确定当前的补偿是否足够支持为住院患者提供CIM.
主要方法:
- 使用2021年洛桑大学医院 (CHUV) 的数据进行了模拟.
- 针对CIM疗法的特殊瑞士干预分类 (CHOP) 代码 (99.BC.12) 被添加到患者记录中.
- 分析了该代码对瑞士DRG退款的影响.
主要成果:
- 2021年,有275名患者接受了CIM治疗.
- 添加CIM CHOP代码99.BC.12导致医院的模拟收入损失为766,630瑞士法郎.
- 医院对CIM的净收益已经超过600万瑞士法郎的赤字.
结论:
- 当前DRG分组算法的激励措施可能会对CIM的提供产生负面影响.
- 未来的支付系统需要紧急改进,以确保足够的患者护理.
- 报销调整是必要的,以支持CIM服务及其潜在的成本节约效益.
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