医院的生产力和价值在按绩效支付的医疗保健计划
Chenzhang Bao1, Indranil R Bardhan2
1Department of Management Science and Information Systems, Spears School of Business, Oklahoma State University, Tulsa, USA.
Health systems (Basingstoke, England)
|May 29, 2025
概括
按绩效支付 (P4P) 计划提高了医院的平均生产力和价值,但许多医院落后. 水平整合促进了两者,而垂直整合只提高了生产力,而不是价值.
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
- 医院管理 医院管理
背景情况:
- 2013年,美国引入了按绩效支付 (P4P) 补偿模式,以将医院支付与质量结果联系起来.
- 这些以价值为基础的举措对医院生产力和医疗保健价值的长期影响仍然不完全理解.
- 有关不同医院P4P计划有效性的潜在差异存在担忧.
研究的目的:
- 评估P4P计划对医院生产力和医疗保健价值的长期绩效影响.
- 分析医院绩效的趋势,使用从2008年到2019年的全国数据集.
- 研究横向和垂直整合对医院生产力和价值的影响.
主要方法:
- 利用数据包裹分析 (DEA) 来衡量医院的绩效.
- 使用马尔姆奎斯特指数来评估生产力和价值的纵向趋势.
- 分析了2008年至2019年美国医院的全国样本.
主要成果:
- 在实施P4P计划后,医院的平均生产力和医疗保健价值均有所改善.
- 很大一部分医院未能跟上绩效前沿的进步,这表明差距越来越大.
- 水平整合与生产率和价值都有积极的相关性.
- 垂直整合 (医生-医院) 与提高生产率有关,但没有改善价值.
结论:
- 虽然P4P计划已经显示出积极的平均效果,但它们的影响是不均的,可能会加剧差距.
- 横向整合似乎是提高医院生产力和价值的有益策略.
- 政策制定者和医院管理人员应该考虑整合策略的差异性影响,并解决基于价值的护理计划中的差异.
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