挑战选择性合同:改革以加强医疗保健中的患者赋权
Gideon Leibner1,2, Devorah Gold3, Gabrielle Foreman3
1Faculty of Medicine, Hebrew University-Hadassah, Jerusalem, Israel. gideon.leibner@mail.huji.ac.il.
Israel journal of health policy research
|March 6, 2025
概括
扩大患者在医疗保健中的选择可以提高质量和竞争,但对社会经济差异的仔细考虑对于公平获取至关重要. 改革旨在提高透明度和患者的决策.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 卫生政策分析 卫生政策分析
- 医疗保健系统比较研究
背景情况:
- 医疗保险公司的选择性合同限制了患者的选择在网络供应商.
- 患者选择改革旨在增加竞争,减少等待时间和提高医疗保健质量.
- 以色列2023年改革扩大了患者的选择和透明度,促使了这项研究.
研究的目的:
- 检查发达国家的选择性合同改革.
- 评估患者选择改革对医疗保健质量,可访问性和社会经济差异的影响.
- 为未来的医疗保健政策提供有关患者选择和公平获取的信息.
主要方法:
- 在PubMed,谷歌学者,经合组织图书馆和欧洲天文台进行文献搜索.
- 关键词包括医疗改革,提供者选择和选择性合同.
- 仅限于2001年以来出版的英语文章.
主要成果:
- 一些国家 (英格兰,葡萄牙) 推出了患者选择改革,而多保险公司系统 (德国,瑞士,荷兰,以色列) 本质上有选择.
- 以色列的改革在选择性合同框架内扩大了医院选择和透明度.
- 增加竞争通常会提高质量,但可能会加剧社会经济差距;透明度工具,如质量指标和安排系统是有益的.
结论:
- 扩大患者选择范围提高了医疗保健系统的效率和患者的赋权.
- 解决社会经济差距对于确保平等获得高质量的护理至关重要.
- 未来的政策应该优先考虑可访问的质量评估和所有患者群体的国家安排系统.
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