捆绑支付计划如何解释患者风险概况的差异? 一个系统的审查
Celine M R Hendriks1, Fiona Koster2, Daniëlle Cattel1
1Department of Health Systems & Insurance, Erasmus School of Health Policy & Management (ESHPM), Rotterdam, South-Holland, The Netherlands; Department of Health Systems & Insurance, Erasmus Centre for Health Economics Rotterdam (EsCHER), Rotterdam, South-Holland, The Netherlands.
概括
捆绑支付计划越来越多地考虑患者风险概况 (PRP),使用排除和风险调整等方法. 然而,大多数方法仍然是基本的,需要改进,以提高医疗保健的价值和公平性.
科学领域:
- 卫生经济学 卫生经济学
- 医疗保健政策 医疗保健政策
- 以价值为基础的护理
背景情况:
- 捆绑支付 (BPs) 是提供高价值护理的日益增长的模式.
- 对患者风险概况 (PRP) 的准确核算对于血压成功至关重要.
- 目前将PRP纳入BP的做法缺乏全面的理解.
研究的目的:
- 系统地审查和分析捆绑支付计划如何考虑患者的风险概况.
- 确定BP内部的PRP会计的常用方法,理由和改进建议.
主要方法:
- 在2024年2月之前,对经合组织国家的BP倡议进行系统的文献审查.
- 提取有关倡议特征,PRP会计方法和改进建议的数据.
- 在各个倡议中进行主题分析和模式识别.
主要成果:
- 分析了来自17个BP倡议的95份文件.
- 患者排除和风险调整是PRP会计的最常见方法.
- 通常使用的风险因素包括并发症和社会人口统计学特征;在价值调整和数据可用性方面需要改进.
结论:
- 捆绑支付计划采用各种方法来解决患者风险差异.
- 对PRP会计的方法正在不断发展,但往往仍然是原始的.
- 设计选择的透明度对于跨倡议学习和比较至关重要.
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