医院和过度使用
Michael Howley1, Prashant Srivastava2
1Department of Marketing, LeBow College of Business, Drexel University, Philadelphia, PA, USA.
Hospital topics
|September 18, 2024
概括
一个被称为超级用户的小组患者推动了医疗保健成本. 研究表明,大量的过度利用与医院无关,医院在这些情况下面临较低的赔偿.
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 医疗经济学
- 医院管理 医院管理
背景情况:
- 在美国,一小部分患者占医疗保健利用和成本的比例不大.
- 过度利用对医院资源和财务表现产生重大影响,但仍然不太了解.
- 识别和管理超级用户是医疗保健系统面临的关键挑战.
研究的目的:
- 探索超能化对美国医院的性质和影响.
- 研究医院如何识别超利用模式的患者.
- 分析过度利用,医院护理和补偿之间的关系.
主要方法:
- 使用2019年医疗支出小组调查 (MEPS) 数据集的探索性研究.
- 基于医疗服务总费用,识别过度利用情况.
- 对医院内超利用病例的费用相对报销的分析.
- 对人口变量进行检查,以确定超利用的预测效用.
主要成果:
- 发现大量的过度利用与医院护理无关.
- 医院的报销额相对于超利用病例的费用有所减少.
- 人口因素在预测过度利用方面表现出有限的有效性.
- 分析表明,潜在的超级用户目前无法获得医院护理.
结论:
- 医院应发展能力,以管理因其高护理要求和财务影响的过度利用.
- 了解超利用的非医院驱动因素对于全面管理至关重要.
- 需要积极的战略来应对超级用户带来的财务和运营挑战.
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