住院时间报告参与捆绑支付计划:2016年至2022年
Ye Tian1, Jixinyi He2, Kira Ryskina3
1David Geffen School of Medicine at the University of California, Los Angeles, USA.
概括
捆绑支付计划对整体住院时间 (LOS) 没有显著影响. 然而,医疗保险支付住宿的参与医院的LOS略有增加.
科学领域:
- 卫生经济学 卫生经济学
- 医疗保健管理的管理
- 医疗保健服务研究 医疗服务研究
背景情况:
- 捆绑支付计划激励跨供应商协调的护理,以提供护理.
- 以前对捆绑支付对住院时间 (LOS) 影响的研究产生了不一致的结果.
- 有限的研究已经检查了跨不同类型的付款人捆绑支付的影响.
研究的目的:
- 评估捆绑支付参与与医院LOS之间的关联.
- 分析不同类别的付款人 (公共和商业) 的这些影响.
主要方法:
- 利用美国医院协会2016年至2022年的调查数据.
- 使用回归分析与相互作用条件和医院/年固定效应.
- 根据付款人类型进行了子组分析.
主要成果:
- 在捆绑支付参与和全付款医院LOS (ATT 0.08天,P=.54) 之间没有发现统计学意义上的关联.
- 在参与捆绑支付医疗保险住院的医疗保险支付住院 (ATT 0.13天,P=.03) 中,观察到LOS的边际增加.
- 对于其他类型的付款人,没有发现显著的LOS变化.
结论:
- 参与捆绑支付计划对医院平均损失的影响是可以忽略不计的.
- 该研究承认潜在的局限性,包括对所有招生中平均LOS的分析,而不是基于特定条件的捆绑支付计划.
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