在中国验证患者驱动支付模式 (PDPM)
Yue Xu1, Mengjia Zhi1, Ningjun Shao2
1School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, 9 Dongdan Santiao, Beijing, 100730, China.
BMC health services research
|May 10, 2025
概括
调整后的患者驱动支付模型 (PDPM) 有效地对中国的急性护理后患者进行了分类,显示了未来支付政策的可靠性和有效性. 这个系统对于中国的发展至关重要.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 医疗保健经济学 医疗保健经济学
- 老年医疗护理 医疗护理
背景情况:
- 在中国,急性病后护理服务正在扩大,但缺乏标准化的支付系统.
- 患者驱动支付模式 (PDPM) 是美国为熟练护理机构患者开发的案例混合系统.
- 本研究评估了适应PDPM的适用性,适用于中国的急性后护理患者.
研究的目的:
- 评估适应的患者驱动支付模型 (PDPM) 的有效性和可靠性,以对中国的急性护理后患者进行分类.
- 确定PDPM是否可以根据临床特征,功能状态和护理需求准确地分组患者.
- 提供证据,为中国未来的后急性护理支付政策提供信息.
主要方法:
- 分析了金华市7家医院 (2018-2020年) 的13,496名急症后护理患者的样本.
- 根据临床数据,功能状态和特殊护理要求,患者被分为PDPM组.
- 用差异解释 (R2),减小差异 (RIV),变化系数 (CVs) 和案例混合指数 (CMIs) 来衡量分类的有效性.
主要成果:
- 调整后的PDPM将患者分为四个组成部分:物理/职业治疗 (PT&OT),语言病理学 (SLP),护理和非治疗辅助 (NTA).
- PDPM解释了PT&OT (11.1%),SLP (6.1%),护理 (14.0%) 和NTA (10.6%) 的日常成本的显著差异,与美国的调查结果相比.
- 分类显示了群体内的良好的同质性,CMI在PT&OT,护理和NTA组件中显示了相当大的范围.
结论:
- 经过调整的PDPM证明了其可靠性和有效性,用于对中国的急性后护理患者进行分类.
- 调查结果表明,PDPM可以作为在中国开发强大的案例混合系统的基础.
- 这项研究支持PDPM的潜在实施,为中国未来的急性后护理支付政策提供信息.
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