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在医院环境中实施的基于价值的支付计划的有效性的证据:系统审查

Shahriyar Mokhtary¹, Ali Janati², Mahmood Yousefi³

¹Health Service Management, School of Management and Medical Informatics, Health Economics Department, Tabriz University of Medical Science, Tabriz, Iran.

Journal of education and health promotion

|October 21, 2024

概括

医院的基于价值的支付计划 (VBP) 的有效性有限. 证据表明,VBP与改善护理结果,效率或患者体验没有一致的联系,通常观察到的效应很小,不显著.

科学领域:

医疗保健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:

基于价值的支付 (VBP) 模式激励医疗保健提供者达到预定义的质量和效率目标.
在医院环境中实施VBP是旨在改善医疗保健服务的日益增长的趋势.

研究的目的:

系统地审查和综合医院基于价值的支付计划有效性的证据.
确定VBP对医疗保健质量,患者结果,效率和患者体验的影响.

主要方法:

对2000年至2022年间发表的研究进行系统审查,在2023年7月通过PubMed,Scopus,Embase和Web of Science进行搜索.
通过专题分析,综合了29篇评估VBP计划的文章的研究结果.
研究被选和评估资格.

主要成果:

VBP与改善的结果没有一致的相关性,例如医院获得的疾病减少或30天死亡率.
对VBP对效率的影响的证据是混合的,很少有研究显示出正面的联系,一些美国研究报告没有或混合的发现.
静脉血压对医疗保健质量,患者体验和成本的影响通常很小且不显著.

结论:

医院目前基于价值的支付计划的有效性没有得到证据的强有力的支持,以显著改善关键结果.
医院对VBP激励的潜在意外负面影响需要在政策制定中仔细考虑.
为了实现所需的医疗保健改进,可能需要进一步的研究和完善的VBP策略.

关键词:

效率效率是指效率是指效率.这是VBP的VBP.评估患者的结果评估.质量质量质量质量质量质量.

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