参与更成熟和更不成熟ACO的医院的结果
Askar Chukmaitov1, David W Harless, David B Muhlestein
1Department of Health Policy, School of Public Health, Virginia Commonwealth University, PO Box 980430, Richmond, VA 23298-0430.
The American journal of managed care
|June 25, 2025
概括
问责护理组织 (ACO) 的成熟度对医院质量和患者安全产生了积极影响. 早期参与显示出更糟糕的结果,但增加ACO成熟度改善了结果,特别是减少了某些不良事件.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 医疗保健管理的管理
- 提高质量 提高质量
背景情况:
- 负责任的护理组织 (ACO) 旨在提高医疗保健的价值.
- 了解ACO成熟度对医院绩效的影响至关重要.
研究的目的:
- 评估ACO成熟度对住院费用,质量和患者安全的影响.
- 将CMS ACO参与者与非参与者进行比较.
主要方法:
- 使用差异差异的准实验性设计 (2010-2013).
- 倾向性得分匹配的医院团体.
- 分析州级医疗保健成本和利用率项目数据.
主要成果:
- 没有ACO成熟度的医院有更高的急性心肌梗塞死亡率和DVT/PE率.
- 增加ACO成熟度与意外刺伤和伤的显著减少有关.
- 在所有指标中没有观察到其他显著趋势.
结论:
- 随着成熟度的增加,医院ACO参与可能会对结果产生积极的影响.
- 局限性包括早期数据和短时间的后续,阻碍了最终的趋势识别.
- ACO成熟度评分为未来影响评估提供了一个有前途的方法.
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