建模医疗保健中按绩效支付计划的成本效益和预算影响
1Frankfurt School of Finance & Management, Adickesallee 32-34, Frankfurt am Main, 60322, Germany. a.gandjour@fs.de.
按绩效支付 (P4P) 计划通过奖励提供者来提高医疗保健质量. 决策建模显示P4P激励措施与预算限制下的取代计划保持一致,优化了成本效益.
科学领域:
- 卫生经济学 卫生经济学
- 改善医疗保健质量 改善医疗保健质量
- 决策建模 决策建模
背景情况:
- 全球越来越多地采用绩效支付 (P4P) 机制,以提高医疗保健质量.
- 这些计划为满足特定绩效目标的医疗保健提供者提供经济激励.
- 了解P4P的成本效益对于优化其实施至关重要.
研究的目的:
- 开发一个决策模型来评估P4P计划的成本效益.
- 确定P4P倡议的最佳激励水平.
- 在各种奖励结构和约束下分析P4P的成本效益.
主要方法:
- 开发了一个决策模型,基于现有的成本效益模型.
- 该模型评估了P4P的成本效益,奖励大小和机制各不相同.
- 场景包括经过和没有预算或时间限制的分析.
主要成果:
- 在没有预算限制的情况下,P4P的增量成本效益比率 (ICER) 是固定的,无论奖励机制如何.
- 当预算或时间限制存在时,P4P激励措施被调整以匹配被替换计划的成本或ICER.
- 该模型在没有预算限制的场景中提供决定性的ICER值.
结论:
- 开发的决策模型准确地评估了P4P计划的成本效益和预算影响.
- 该模型容纳了各种奖励机制和操作场景.
- 它有效地评估了P4P的实施,无论是否有财务和时间限制.
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