医院再接收减少计划惩罚医院临床医生安全网
Sarah Kirsch1, Yousra Elsir, Katie Shelford
1Sarah Kirsch practices in critical care at Northwell Health, North Shore University Hospital, in Manhasset, N.Y. Yousra Elsir practices in urology oncology surgery at Stanford Health Care in Palo Alto, Calif. Katie Shelford practices in bariatric surgery at Community Health Network in Indianapolis, Ind. Janessa Vail practices in critical care at Saint Francis Hospital & Heart Center in Roslyn, N.Y. Anne Wildermuth is an assistant professor in the School of Medicine at the Uniformed Services University of the Health Sciences in Bethesda, Md., and practices in emergency medicine at MedStar Emergency Physicians in Clinton, Md. The authors have disclosed no potential conflicts of interest, financial or otherwise.
医院再录取减少计划 (HRRP) 可能会通过不考虑其计算中的社会因素来加剧医疗保健差异. 修改HRRP风险调整可以帮助弱势群体并减少处罚.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 健康差异 在健康上的差异
- 医疗保健政策 医疗保健政策
背景情况:
- 医院再录取减少计划 (HRRP) 旨在提高医疗保健质量并降低成本.
- 目前的HRRP风险调整计算不包括健康的社会决定因素.
- 这种遗漏不成比例地影响弱势患者群体,并可能导致临床医生和医院受到不公平的处罚.
研究的目的:
- 调查社会因素对HRRP风险调整计算的影响.
- 探索社会风险因素,医疗保健差异和医院处罚之间的关系.
- 确定HRRP的潜在修改,以减轻意外后果.
主要方法:
- 进行了PRISMA系统文献审查.
- 搜索了PubMed和Cochrane图书馆的相关研究.
- 分析了过去10年发表的15篇文章,重点关注社会因素和HRRP.
主要成果:
- 73%的审查文章 (共15篇11篇) 发现HRRP风险调整计算加剧了医疗保健差异.
- 有证据表明,排除社会因素与增加差距之间存在联系.
结论:
- 将社会风险因素纳入HRRP计算可以促进为服务于弱势患者的医院提供公平补偿.
- 修改HRRP对于减少负面的意外后果和医疗保健差异至关重要.
- 需要进一步的研究来确认社会风险因素的影响,并指导HRRP修改.
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