利益相关者对从质量改进倡议中获取社会成本节约的观点:定性研究
Daniëlle Kroon1, Simone A van Dulmen1, Niek W Stadhouders1
1Department of IQ Health, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands.
像预康复这样的质量改善举措可以节省成本,但要实现这些节省,需要在各个阶段解决障碍. 需要一个全面的战略来将减少的利用转化为实际的社会成本节省.
科学领域:
- 医疗服务研究 医疗服务研究
- 医疗保健管理的管理
- 卫生经济学 卫生经济学
背景情况:
- 质量改善举措旨在提高护理质量,降低成本.
- 预康复是减少并发症和住院时间的举措的典范.
- 将利用率的减少转化为社会成本的节约,面临着实际的不确定性.
研究的目的:
- 确定在将质量改进举措转化为社会成本节约方面的障碍和促进者.
- 以荷兰一家医院的预康复实施为案例研究来分析这一过程.
主要方法:
- 与18家医院的利益相关者和2家医疗保险公司进行了20次半结构面试.
- 采访被录制,转录和归纳编码.
- 分析涉及在四个定义阶段识别障碍和促进者.
主要成果:
- 在不同阶段确定了20个障碍和23个促进者:减少能力,部门,医院和保险公司费用.
- 利益相关者预计将节省的产能重新分配给其他优先事项,将其视为效率提升.
- 障碍包括:害怕失去性,地位和收入;医院和保险公司之间的合同不一致;以及阻碍降低成本的财政激励措施.
结论:
- 系统地描述了阻碍质量改进转化为社会成本节约的障碍和促进因素.
- 利益相关者预计,节省的容量将用于增加对护理服务的需求.
- 获取财务节省并不是自动的,需要一个针对过程的所有阶段的策略.
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