影响全加拿大的风湿病科医生和以患者为中心的护理的服务费报酬不平等:环境扫描
Timothy S H Kwok1, Shirley Lake2, Claire E H Barber3
1T.S.H. Kwok, MD, MSc, Division of Rheumatology, Department of Medicine, Temerty Faculty of Medicine, University of Toronto, and Sunnybrook Research Institute, Holland Bone and Joint Program, Toronto, Ontario, Canada.
The Journal of rheumatology
|March 5, 2025
概括
加拿大类风湿病治疗因疾病负担上升和劳动力短缺而面临难以获得的挑战. 服务费结构在各省之间有很大差异,影响了对类风湿病服务的公平获取.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 类风湿病学 类风湿病学
- 卫生政策 卫生政策
背景情况:
- 风湿和肌肉骨疾病在加拿大正在增加,这给风湿病学服务带来了压力.
- 预计越来越严重的劳动力赤字加剧了接入挑战.
- 医生的薪酬显著影响医疗保健的获取和质量.
研究的目的:
- 为了比较加拿大各省的风湿病学服务的服务费报酬结构.
- 评估补偿结构是否支持以人为中心的护理,特别是获得护理.
主要方法:
- 对公共资助的计费代码和常见类风湿病学服务的报销费进行了环境扫描.
- 截至2024年7月,收集了所有加拿大省份的数据.
- 分析了补偿结构,以支持以人为中心的护理.
主要成果:
- 在新咨询 (加拿大153.51美元239.57美元) 和后续访问 (加拿大65.55美元131.52美元) 的报销费用方面,存在显著的省级差异.
- 发现了复杂患者计费率的差异,虚拟护理资金不一致,对多学科护理模式的支持稀缺.
- 对于注射和护理点超声波等程序,还注意到了各省的差异.
结论:
- 在风湿病学服务资金方面的省级差异引发了重大的卫生政策问题.
- 建议包括减少工资差异,消除以人为中心的护理障碍,以及优化加拿大服务标准化.
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