胃肠道瘤手术发作的结局 综合支付改善护理高级计划
Keenan J Robbins1, Jie Zheng2, E John Orav3,4
1Department of Surgery, Washington University School of Medicine, St. Louis, MO.
捆绑支付计划,如捆绑支付护理改进先进 (BPCI-A),没有降低成本或提高胃肠癌手术的质量. 需要对长期影响进行进一步的研究.
科学领域:
- 医疗经济学
- 癌症外科手术
- 支付改革
背景情况:
- 跨学科的癌症治疗是复杂而昂贵的.
- 对于化疗和放射治疗, 医疗保险有替代的支付模式.
- 癌症手术并不是支付改革的直接目标.
研究的目的:
- 评估BPCI-A参与与财务和临床结果的关联.
- 分析BPCI-A对为恶性瘤进行胃肠道手术的患者的影响.
主要方法:
- 使用100%医疗保险数据的回顾性队列研究 (2017年1月 - 2019年9月).
- 比较BPCI-A医院与非参与医院的手术发作情况.
- 评估90天的医疗保险支付,再入院,死亡率和在家的健康日的变化.
主要成果:
- 参与BPCI-A没有显著减少胃肠道恶性瘤手术的医疗保险支付.
- 在BPCI-A参与者的再入院率,死亡率或健康日均没有显著改善.
- 在BPCI-A参与者和非参与者之间,恶性与良性疾病的支出变化相似.
结论:
- 综合支付改善高级 (BPCI-A) 参与与胃肠癌手术的成本节约或质量改善无关.
- 长期影响和对瘤结果的影响需要进一步研究.
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