在参与私人保险共享储蓄模式的瘤科医生中,利用率和成本
Brigham Walker1, Lalan Wilfong, Nicholas Robert
1Tulane University, 1440 Canal St, Ste 1937, New Orleans, LA 70112.
The American journal of managed care
|June 23, 2025
概括
私人付款人共享储蓄计划 (SSP) 降低了结肠癌护理的成本,并显示了对肺癌的一些节省. 乳腺癌护理费用没有受到影响,这表明这些瘤支付模式的影响各不相同.
科学领域:
- 在瘤学瘤学.
- 卫生经济学 卫生经济学
- 医疗保健管理的管理
背景情况:
- 瘤护理模型 (OCM) 影响了护理利用率和成本.
- 人们对基于私人付款者的瘤学模型的影响知之甚少.
- 本研究研究了一家私人保险公司的共享储蓄计划 (SSP).
研究的目的:
- 评估基于私人付款人的共享储蓄计划 (SSP) 对护理利用率和成本的影响.
- 为了比较参与与非参与瘤实践的成本模式.
- 评估不同类型癌症 (乳腺癌,结肠癌,肺癌) 的影响.
主要方法:
- 对瘤学索赔数据进行准实验 (差异差异) 分析.
- 从2014年9月到2017年8月使用了提供者级月度索赔.
- 比较每月平均办公室访问,总成本和购买和发票药物成本参与前后.
主要成果:
- 结肠癌 (1391美元/患者) 和肺癌 (1050美元/患者) 的第一年节省.
- 结肠癌的储蓄在第二年增加;肺癌的储蓄消失了.
- 没有发现对乳腺癌患者的成本有重大影响.
结论:
- 基于私人付款者的SSP可能会降低特定癌症类型的成本,比如结肠癌.
- 关于降低肺癌成本的证据较弱,而乳腺癌则不存在.
- 异质效应凸显了在瘤支付改革中需要量身定制的模型开发的需要.
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