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医院医学的护理模式:使用蒙特卡洛方法对先进实践者利用的分析
Rohit Sharma1, Noora Akram2, Michael Madden3
1Department of Medicine, Mass General Brigham, Boston, MA, USA.
The Permanente journal
|April 17, 2025
概括
对于医院医疗雇主来说,对高级实践从业者的直接监督比间接监督更具成本效益. 鉴于APP在解决医生短缺问题上的作用越来越大,这一发现至关重要.
科学领域:
- 卫生经济学 卫生经济学
- 医疗保健管理的管理
- 临床操作 临床操作
背景情况:
- 由于人口老龄化和医疗保健需求增加,美国医生短缺正在恶化.
- 先进实践从业者 (APP),包括执业护士和医生助理,越来越多地融入医疗保健工作人员.
- APP的实践自主程度各不相同,需要对最佳监督模式进行评估.
研究的目的:
- 确定医院医学部门高级实践医师 (APP) 监督的最佳财政模式.
- 为了比较直接与间接监管对APP的成本效益.
主要方法:
- 使用R软件进行蒙特卡洛模拟,以模拟APP护理交付.
- 为了构建模拟模型,使用了公开可用的工资数据和典型的计费做法.
- 模拟代表了典型的医院医疗保健团队,包括医生和APP.
主要成果:
- 分析表明,在目前的报销结构下,APP对于医院医疗护理团队至关重要.
- 与间接监督相比,APP的直接监督导致雇主每工作相对价值单位的成本较低.
- 该研究考虑了一系列模拟场景.
结论:
- 高级实践从业人员将继续增加他们对计费医疗保健访问的贡献.
- 建议进行直接监督,以从财务角度优化医院医疗护理团队,考虑到当前的付款人和工资限制.
- 这项研究为医院医学中的APP监督模型提供了信托观点.
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