对放射学和低价值成像技术的费用削减.
David H Howard1, Michal Horný2, Marcus Dillender3
1Department of Health Policy and Management, Emory University, 1518 Clifton Road NE, Atlanta, GA, 30322, USA. david.howard@emory.edu.
减少医疗保险支付前列腺癌成像的费用并没有减少其使用,即使是低风险患者. 这表明医生支付水平可能不会影响医疗服务的订购.
科学领域:
- 卫生经济学 卫生经济学
- 医疗成像利用的利用方法
- 前列腺癌的护理和治疗
背景情况:
- 服务费偿还模式可能会激励过度使用昂贵的医疗程序.
- 政策制定者旨在减少对低价值医疗保健服务的支付,以控制成本.
研究的目的:
- 评估大幅降低支付对使用常见前列腺癌成像程序的影响.
- 确定减少补偿是否会影响医生对前列腺癌患者成像治疗的决定.
主要方法:
- 使用差异差异模型.
- 链接医疗保险索赔数据与癌症登记记录以进行全面分析.
- 专注于经常用于前列腺癌管理的特定成像程序.
主要成果:
- 减少支付并没有导致针对性成像程序的使用情况发生重大变化.
- 即使在不需要手术的低风险前列腺癌患者中,成像使用仍然不受影响.
- 调查结果表明,在特定的医疗保健环境中,服务使用与费用水平的潜在脱.
结论:
- 医生支付水平可能不是使用某些医学成像服务的主要驱动因素.
- 转诊医生的决定,而不是执行医生的补偿,似乎是影响服务使用的关键因素.
- 针对降低费用的政策干预可能无法有效制潜在的低价值服务的使用,因为订购决策是由医生决定的.
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