影响农村医院决定加入替代支付模式的因素:混合方法研究
Kimberly J Rak1, Donald S Bourne2, Jacqueline Barnes3
1Kimberly J. Rak (kjr8@pitt.edu), University of Pittsburgh, Pittsburgh, Pennsylvania.
Health affairs (Project Hope)
|July 7, 2025
概括
农村医院加入了宾夕法尼亚农村卫生模式 (PARHM),以获得财务稳定和独立. 不参与这种替代支付模式 (APM) 的决定是由对运营自主性的渴望所驱动的.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 医疗保健政策 医疗保健政策
- 农村卫生 农村卫生
背景情况:
- 自愿替代支付模式 (APM) 影响医院的评估和绩效.
- 宾夕法尼亚农村卫生模式 (PARHM) 是一个自愿的APM,结合了全球预算和护理转型.
研究的目的:
- 检查影响医院参与PARHM决策的因素.
- 了解加入或不加入自愿农村APM背后的动机.
主要方法:
- 混合方法研究结合了定量和定性分析.
- 对PARHM前医院特征的定量分析.
- 对来自参与和非参与医院的医院管理人员的采访进行了定性分析.
主要成果:
- 加入PARHM的医院总利率较低,出院人数较少,并且更有可能独立.
- 参与的动机包括改善金融稳定性和保持独立性.
- 不参与的原因集中在维护运营自主性和未来增长灵活性.
结论:
- 医院参与像PARHM这样的自愿APM受到财务和运营考虑的平衡的影响.
- 结果可以为未来的APM的设计和定位提供信息,特别是在农村医院.
- 了解这些因素对于制定有效的医疗保健政策至关重要.
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