用一个质量标签轻轻地引导他们? 在没有经济激励的情况下,对患者道化策略的案例研究分析
Stéphanie A van der Geest1,2, Marco Varkevisser1,2
1Erasmus School of Health Policy & Management (ESHPM), Erasmus University Rotterdam, Rotterdam, Netherlands.
The International journal of health planning and management
|August 24, 2024
概括
荷兰的一家医疗保险公司.
科学领域:
- 卫生经济学 卫生经济学
- 医疗保健管理的管理
- 医疗服务研究 医疗服务研究
背景情况:
- 医疗保健系统的目标是通过引导患者选择更高质量或更低成本的提供者来增加价值.
- 医疗保险公司可能会使用财务激励或软道策略来影响患者选择医疗服务提供者.
- 基于质量标签的非金融提供者建议的有效性仍然不清楚.
研究的目的:
- 调查荷兰医疗保险公司"TopCare"质量标签对患者选择医院进行乳腺癌手术和 inguinal hernia修复的影响.
- 为了确定没有经济激励的推首选医院是否有效地引导患者的行为.
- 分析患者在引入质量标签之前和之后的选择模式.
主要方法:
- 利用来自医疗保险公司的个人患者级索赔数据,跨越5年 (2006-2010).
- 采用条件逻辑选择模型来分析医院选择.
- 检查了患者选择的乳腺癌手术 (7985名患者) 和 inguinal 修复 (17,292名患者).
主要成果:
- 在引入质量标签之前,患者已经表现出对指定"TopCare"医院的偏好.
- 在推出"TopCare"标签之前和之后,没有观察到患者选择医院的显著变化.
- 质量标签没有明显增加患者对保险公司首选医院的需求.
结论:
- 医疗保险公司推首选医院的策略仅基于质量标签,没有经济激励,在影响患者选择方面无效.
- 患者对特定医院的偏好可能已经存在,并且不易被非财务质量指标改变.
- 没有财政激励的软道策略可能不是保险公司将患者引导到首选提供者的可行方法.
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