医生的利他主义和支出,住院和急诊室的访问
Lawrence P Casalino1, Shachar Kariv2, Daniel Markovits3
1Deptartment of Population Health Sciences, Weill Cornell Medical College, New York, New York.
JAMA health forum
|October 11, 2024
概括
医生利他主义与更好的患者结果和更低的医疗保健成本有关. 研究表明,利他主义的医生有较少可预防的住院和急诊,总体支出减少.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 医学经济学 医学经济学
- 医生行为 医生行为
背景情况:
- 医生的利他主义,优先考虑患者的福祉,对于专业的医疗实践至关重要.
- 医生利他主义,医疗保健质量和支出之间的相关性存在有限的证据.
研究的目的:
- 研究医生利他主义,医疗保健质量指标和患者支出之间的关系.
- 为了测试假设,利他主义医生实现优越的患者结果.
主要方法:
- 一项采用经过验证的经济实验来量化医生利他主义的横截面研究.
- 来自250名美国初级保健医生和心脏病专家的数据 (2018年10月至2019年11月) 与医疗保险索赔有关.
- 多变量回归分析了利他主义,质量措施 (可预防的入院/ED访问) 和支出之间的关联.
主要成果:
- 利他主义医生的患者显示潜在可预防的入院 (OR,0.60) 和急诊室访问 (OR,0.64) 的可能性显著降低.
- 医疗保险支出被调整为低于9.26%的患者治疗的利他主义医生 (P=.01).
- 用修改的独裁者游戏风格基于网络的实验来测量利他主义.
结论:
- 医生利他主义与改善护理质量和减少医疗保健支出有关.
- 医疗保健领导人应该考虑培养支持医生利他主义的环境.
- 建议进行进一步的研究,以探索影响利他主义的可修改因素及其在不同环境中的影响.
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