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参与ACO和非参与者医院市场份额的趋势
Mariétou H Ouayogodé1, Xiaodan Liang, David B Muhlestein
1University of Wisconsin School of Medicine and Public Health, 610 Walnut St, Madison, WI 53726.
医疗保险负责任护理组织 (ACO) 的医院总是比非参与者拥有更大的市场份额 (MS). 基线MS是未来增长的最强有力的预测指标,强调需要监测集中市场的ACO.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 医疗保健经济学 医疗保健经济学
- 卫生政策 卫生政策
背景情况:
- 负责任的护理组织 (ACO) 旨在提高医疗保健质量和降低成本.
- 了解ACO参与对医院市场动态的影响对于政策和竞争分析至关重要.
研究的目的:
- 分析参与医疗保险ACO的医院与非参与者的市场份额 (MS) 趋势.
- 确定与这些集团之间的市场份额差异相关的因素.
主要方法:
- 一项纵向研究分析了2011-2020年美国3534家短期急性护理医院的数据.
- 使用医院转诊区域 (HRR) 内的患者净收入,出院和病床计算了市场份额.
- 多变量回归研究了ACO参与,MS和市场集中 (Herfindahl-Hirschman指数) 之间的关联.
主要成果:
- 与非参与者相比,ACO参与者在所有措施中都显示出更大的市场份额.
- ACO参与与平均市场份额增加1.6-2.0个百分点有关.
- 在集中市场中,ACO参与和市场份额之间的积极关联更为明显.
- 2011年的基准市场份额是随后市场份额增长的最重要的预测指标.
结论:
- 医疗保险ACO中的医院在市场份额方面保持了竞争优势.
- 建议在ACO进入之前管理竞争,并监控参与集中市场的情况.
- 由于ACO参与,市场份额的潜在增长需要进一步评估,以确保保持质量和患者福利.
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