调整风险调整:考虑组织之间的差异,以满足其支出需求的响应能力
Sean Urwin1, Laura Anselmi1, Emmanouil Mentzakis2
1Health, Organisation, Policy and Economics, School of Health Sciences, University of Manchester, United Kingdom.
Social science & medicine (1982)
|October 5, 2024
概括
将医疗保健预算建立在历史数据的基础上,可能会忽略未满足的需求. 一种新的测量方法.
科学领域:
- 卫生经济学 卫生经济学
- 公共卫生政策 公共卫生政策
- 医疗保健管理的管理
背景情况:
- 医疗保健预算分配通常依赖于使用历史利用数据进行风险调整.
- 这种方法可能会延续未满足的健康需求,因为它没有充分考虑人口的健康要求.
- 准确的风险调整对于医疗保健中公平的资源分配至关重要.
研究的目的:
- 提出和评估一种新的医疗保健预算风险调整方法,以考虑"支出对需求的响应性".
- 评估从风险调整模型中删除低响应度组织对资源配置的影响.
- 调查支出响应能力与健康结果,特别是自杀率之间的关联.
主要方法:
- 利用英格兰急性医院和二级精神卫生服务的国家个人级数据开发了"支出对需求的响应性"的衡量标准.
- 估计了当地卫生组织的响应度.
- 重估了国家风险调整模型,排除了支出反应率最低的组织的数据.
主要成果:
- 在卫生服务和组织中观察到支出响应能力的显著差异.
- 在精神卫生服务中,更高的支出响应度与自杀率的降低相关.
- 排除了响应能力低于平均水平的组织,导致对最需要的人群的年度医疗保健需求估计增加:急性护理为163英 (7%) 和精神卫生服务为79英 (27%).
结论:
- 拟议的"支出对需求的响应性"措施为医疗保健风险调整提供了更公平的方法.
- 调整风险调整模型,不包括响应较弱的组织的数据,可以更好地将资源转向需要高的人群.
- 实施这种方法可以改善资源分配,确保服务与实际人口健康要求保持一致,并可能改善结果.
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