在ACO中,教学医院为商业受益者提供了什么价值?
Matthew C Baker1, Theresa R F Dreyer, Erin Naomi Hahn
1Association of American Medical Colleges, 655 K St NW, Ste 100, Washington, DC 20001.
The American journal of managed care
|September 17, 2024
概括
具有主要教学医院的负责任的护理组织 (ACO) 显示出更好的基于价值的护理结果. 这些教学ACO的死亡率和支出较低,突出了它们在实现医疗保健目标方面的有效性.
科学领域:
- 医疗保健管理的管理
- 以价值为基础的护理
- 医疗保健服务研究 医疗服务研究
背景情况:
- 商业受益者在负责任的护理组织 (ACO) 的入学人数正在增加.
- 有限的研究存在于商业ACO中的趋势.
研究的目的:
- 为了比较医疗保险共享储蓄计划 (Medicare Shared Savings Program ACOs) 的受益人与主要教学医院和没有主要教学医院的结果.
- 分析商业ACO的死亡率和支出趋势.
主要方法:
- 对2019-2021年商业索赔数据的分析.
- 将受益人归因于教学与非教学ACO的比较.
- 按环境和年份计算死亡率和支出.
主要成果:
- 主要教学ACO的死亡率较低 (高达2.2个百分点),住院费用较低 (每受益人283美元).
- 教学ACO显示急诊室利用率降低,但整体门诊支出较高 (146美元).
- 在COVID-19期间,这两种ACO类型的死亡率和风险得分都增加了,这表明健康结果受到干扰.
结论:
- 拥有大型教学医院的ACO似乎更有利于实现基于价值的护理目标.
- 策略可能包括减少高强度护理和促进具有成本效益的门诊服务.
- 及时,高质量的门诊护理可以减少住院和急诊室的利用率.
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