每位受益人的医院医疗保险支出:一个纵向研究
Jing Xu, Hanadi Hamadi, Mei Zhao1
1Department of Health Administration, Brooks College of Health, University of North Florida, Jacksonville, Florida.
概括
医院的特点对医疗保险和医疗补助服务中心 (CMS) 医院价值基础采购 (HVBP) 计划的效率领域的表现产生重大影响. 一些医院由于其结构而面临不利因素,这表明需要在绩效支付计划中提供更明确的激励措施.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 卫生经济学 卫生经济学
- 医院管理 医院管理
背景情况:
- 有限的研究存在于付费绩效 (PFP) 计划的财务影响,特别是医疗保险和医疗补助服务中心 (CMS) 医院价值基础采购 (HVBP) 计划的效率和成本降低领域.
- 了解医院成本低效率与HVBP计划绩效之间的关系对于优化医疗保健支出至关重要.
研究的目的:
- 检查医院成本低效率与参与HVBP计划之间的关联.
- 估计在HVBP计划的效率和成本降低领域的改进或成就的概率和规模.
主要方法:
- 利用CMS的2014-2019年效率和成本降低领域数据,与美国医院协会的年度调查数据库合并.
- 采用零膨胀负二项式回归来分析数据,考虑过多的零值.
主要成果:
- 医院的所有权,位置,规模,安全网状态,医疗保险患者百分比和每张床位的护士是影响效率的重要因素.
- 赫芬达尔 - 希尔什曼指数和教学地位也显示出对HVBP计划的效率表现产生重大影响.
结论:
- 医院在效率和成本降低领域的表现已经进化,固有的组织结构可能使某些医院处于不利地位.
- 目前的HVBP计划可能缺乏对所有利益相关者的明确方向或可操作的激励措施,特别是在每位受益人的医疗保险支出方面.
- 研究结果为决策者,管理者和研究人员提供了实用价值,以改进PFP计划,改善资源配置和提高医疗保健系统效率.
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