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医院医生垂直整合对医生药物开支和使用的影响
Jonathan S Levin1, Xiaoxi Zhao2, Christopher Whaley3
1RAND Health Care, RAND Corporation, Arlington, Virginia, USA.
Health economics
|November 13, 2024
概括
医院-医生垂直整合通过将护理转移到医院,增加了医生管理药物的支出. 这一趋势在血液瘤学,眼科和风湿病学中观察到,提高了整体医疗保健成本.
科学领域:
- 卫生经济学 卫生经济学
- 医疗保健管理的管理
- 临床药理学 临床药理学
背景情况:
- 医院和医生之间的垂直整合是医疗保健中日益增长的趋势.
- 了解其对医疗保健支出和药物使用的影响对于政策制定至关重要.
研究的目的:
- 估计医院-医生垂直整合对医生药物开支和使用的影响.
- 分析这些影响在血液学-瘤学,眼科和风湿病学专业.
主要方法:
- 从2013年到2017年使用了100%的医疗保险服务费医疗索赔样本.
- 分析了治疗地点 (医生办公室与医院门诊部门) 的变化以及相关的药物支出.
主要成果:
- 纵向整合将治疗从医生办公室转移到医院门诊部门.
- 医生管理的药物管理支出每次手术在所有三种专业增加.
- 医疗保险B部分药物的支出增加了血液学家-瘤学家.
- 通过受益者和药物输注计数来衡量治疗强度,下降.
结论:
- 医疗保险补偿激励措施,包括护理地点支付和门诊药物费率,与垂直整合相互作用,推动整体支出增加.
- 政策和合并准则应解决垂直整合问题,以抑制医疗保健成本的增加.
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