医院价格标记和主要选择性手术的结果
Sara Sakowitz1,2, Syed Shahyan Bakhtiyar1,3, Yas Sanaiha1,4
1Department of Surgery, University of California, Los Angeles.
JAMA surgery
|September 24, 2025
概括
高附加费医院 (HMH) 的费用远高于其成本,并且与患者的治疗结果更差有关. 这些发现突显了HMH作为定价和质量改善政策变革的目标.
科学领域:
- 卫生经济学 卫生经济学
- 医疗保健服务研究 医疗服务研究
- 医疗质量 医疗质量
背景情况:
- 美国医院价格缺乏监管,影响患者,纳税人和政府.
- 了解医院价格加价的国家差异对于基于价值的护理至关重要.
- 以前的研究还没有完全界定美国医院价格加价的全国变化.
研究的目的:
- 描述主要可选手术医院价格加价的国家差异.
- 评估医院价格加价和术后结果之间的关联.
- 评估医院价格加价和整体护理质量之间的关系.
主要方法:
- 一项国家横截面研究分析了来自2022年全国再录取数据库的数据.
- 机构标记比率 (MRs) 计算了1960年美国医院进行4项主要选择性手术.
- 高增值医院 (HMH) 被定义为位于MRs的上十分之一的医院.
主要成果:
- 医院中位数价格加值系数为3.0;HMH的中位数MR为8.5.
- HMH往往是投资者拥有的,营利性的,位于大都市地区.
- 在HMH的护理与增加重大发病率和30天非选择性再入院的几率有关.
结论:
- 医院价格加价在美国各医院存在显著差异.
- 高额附加费的医院表明护理质量和价值较低.
- 价格监管,透明度和质量改善应成为国家政策的首要目标.
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