熟练护理设施的基于价值的采购未能实现医院再接收减少和其他目标
Robert E Burke1, Franya Hutchins2, Jonathan Heintz3
1Robert E. Burke (robert.burke2@pennmedicine.upenn.edu), University of Pennsylvania and Corporal Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia, Pennsylvania.
Health affairs (Project Hope)
|June 2, 2025
概括
熟练护理设施价值基础采购 (SNF VBP) 计划没有减少医疗保险受益人的医院再入院. 这一大规模的绩效支付计划没有对再接收,死亡率或出院率产生影响.
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
- 老年学是指老年学的学科.
背景情况:
- 熟练护理设施价值基础采购 (SNF VBP) 计划是医疗保险最大的绩效支付计划.
- 它鼓励熟练护理机构 (SNFs) 减少急性护理后患者的30天住院再接收.
研究的目的:
- 评估SNF VBP计划在减少30天再入院的有效性.
- 评估该计划对死亡率,停留时间和社区出院率的影响.
主要方法:
- 使用2011-2021年医疗保险数据进行了差异分析.
- 在医疗保险支付床位日的最高和最低四分位数中的SNF之间比较了患者的结局.
主要成果:
- 该SNF VBP计划没有显著影响30天的再入院.
- 没有观察到对30天死亡率,SNF停留时间或100天社区出院率的影响.
结论:
- 实施的SNF VBP计划没有实现其减少医院再入院的目标.
- 持续的监测和进一步的研究是必不可少的,特别是考虑到最近的计划变化,以告知未来的SNF质量改进政策.
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