使用第二次医疗意见作为支付方式的函数
1Department of Management, Bar-Ilan University, Ramat-Gan, 52900, Israel. liora.shmueli@biu.ac.il.
BMC health services research
|February 26, 2025
概括
患者的付款方式会影响寻求第二次医疗意见 (SO). 2015年的一项改革将SO使用转移到共同支付轨道,影响利用模式并突出激励和地理位置的作用.
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
- 医疗决策的制定 医疗决策的制定
背景情况:
- 患者对医疗服务的决策受成本和支付方式的影响,这是兰德医疗保险实验 (HIE) 所证明的.
- 本研究考察了通过不同的支付途径,对附加医疗保险持有者的第二次医疗意见 (SO) 的使用:财政补偿和网络.
- 2015年的监管改革取消了外科医生SO咨询的直接退款,改变了利用的格局.
研究的目的:
- 为了估计在2015年"网络补偿安排"改革之前和之后的SO利用模式.
- 在改革之前,确定与每个支付轨道相关的人口和临床预测因素.
- 了解支付结构的变化如何影响患者寻求专业医疗咨询的选择.
主要方法:
- 追溯分析来自Clalit健康服务的二次护理和补充保险索赔数据.
- 一个算法通过使用电子医疗记录的支付方式识别了SO实例.
- 多变量后勤回归分析了SO寻求者的特征,按支付方式.
主要成果:
- 从2015年到2017年,患者对通过共同支付途径进行SO咨询的需求在改革后增加了28%.
- 在改革前",网络轨道"受到阿拉伯部门患者,低社会经济群体,移民和中部地区居民的青.
- 在改革前",财政补偿轨道"是外围地区居民和犹太东正教社区的首选.
结论:
- 提供者支付方式,类似于激励结构,解释了跨不同健康计划或支付轨道寻求专家的变化.
- 除了成本之外的因素,例如地理位置接近提供商,影响了SOs的支付方式选择.
- 分析利用模式对于评估对医疗保健支出,政策,临床结果和患者满意度的监管影响至关重要.
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