评估长期护理需求的战略编码:来自法国的证据
1Institut des Politiques Publiques (PSE-GENES), Paris School of Economics (PSE), Ecole des Hautes Etudes en Sciences Sociales (EHESS), Paris, France.
Health economics
|February 12, 2025
概括
医疗保健提供者战略性地编码患者的残疾以影响收入和护理. 养老院可能会夸大残疾收入,而社区评估员可能会低估它以减少支付.
科学领域:
- 卫生经济学 卫生经济学
- 社会老年学 社会老年学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 医疗保健提供者可以从事
- 上升编码"通过夸大疾病严重程度来膨胀计费收入.
- 对于长期护理资格的患者评估中的战略编码实践的理解较少.
- 患者对长期护理的评估受评估代理人的激励因素的影响.
研究的目的:
- 调查评估剂的激励如何影响患者对长期护理资格的评估.
- 用法国独特的链接调查数据集记录患者评估中的战略编码.
主要方法:
- 使用了法国独特的链接调查数据集.
- 根据评估代理人的类型 (养老院与社区评估员) 分析了患者评估数据.
- 检查了影响残疾升级编码的因素,包括设施所有权和患者特征.
主要成果:
- 养老院评估患者比社区评估员更具残疾,可能增加收入.
- 公立医院拥有的长期护理设施显示,残疾人过度评价的比例更高.
- 认知障碍或处于社会不利地位的患者更容易患上残疾.
- 社区评估人员可以将残疾编码下来,将护理责任转移给非正式的照顾者.
结论:
- 患者对长期护理的评估受到评估代理人的财务和运营激励因素的重大影响.
- 养老院的升级编码可能源于评估工具的局限性和资金需求.
- 社区评估人员的下编码可能会影响非正式护理网络的负担.
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