参与护理和直接初级保健的诊所和临床医生的数量增长, 2018-23
Jane M Zhu1, Trisha Marsh2, Daniel Polsky3
1Jane M. Zhu (zhujan@ohsu.edu), Oregon Health & Science University, Portland, Oregon.
Health affairs (Project Hope)
|December 2, 2025
概括
门店和直接初级保健实践正在迅速扩大,现场和临床医生的数量大幅增长. 劳动力正在转向高级实践临床医生,企业所有权正在增加.
科学领域:
- 医疗保健管理的管理
- 初级保健模式的初级保健模式
- 医疗保健服务研究 医疗服务研究
背景情况:
- 临床医生对替代初级保健模式越来越感兴趣,例如护理员和直接初级保健.
- 与传统实践相比,这些模型提供了更小的患者小组和更大的临床自主权.
研究的目的:
- 评估管理员和直接初级保健 (DPC) 实践的实践和劳动力特征.
- 在这些模型中分析所有权,临床医师组成和参与医疗保险的趋势.
主要方法:
- 采用了全国范围内的门将和DPC实践样本.
- 采用公开和专有信息的新型数据链接进行分析.
- 从2018年到2023年检查的数据.
主要成果:
- 观察到显著增长:实践场所增加83.1%,参与临床医生增加78.4% (2018-2023年).
- 临床医生组成的转变:医生份额从67.3%下降到59.7%,而高级实践临床医生增加.
- 企业关联的增加:独立所有权从84.0%下降到59.7%,企业关联实践增长了576%.
- 这些实践中的大约60%的临床医生参与医疗保险,表明混合型号.
结论:
- 门店和DPC模型正在经历实质性的增长,这表明初级保健的显著转变.
- 不断变化的劳动力和日益增长的企业参与引发了关于临床实践和患者获取权的重要问题.
- 需要进一步的研究来了解这些趋势对医疗保健的长期影响.
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