基于价值的医疗服务定价与健康公平考虑
Luigi Siciliani1, Simon Walker2, David Glynn3
1Department of Economics and Related Studies, University of York, Heslington, York YO10 5DD.
概括
本研究介绍了一种将公平纳入医疗保健定价的方法,评估按绩效支付计划如何影响社会经济群体的健康. 它展示了如何调整激励措施以减少健康不平等.
科学领域:
- 卫生经济学 卫生经济学
- 公共卫生政策 公共卫生政策
- 医疗保健服务研究 医疗服务研究
背景情况:
- 全球卫生系统都致力于减少健康不平等.
- 绩效支付计划是政策工具,旨在使提供者行为与卫生系统目标保持一致.
- 基于价值的定价是医疗补偿的关键机制.
研究的目的:
- 开发一种方法来将股权问题纳入英格兰国家卫生服务机构的基于价值的定价.
- 分析社会经济地位对健康结果的影响.
- 评估质量成果框架 (QOF) 的修改如何影响社会经济群体之间的健康分布.
主要方法:
- 利用结合分布式成本效益分析和合同理论的理论框架.
- 使用成本,健康益处,成绩率和价格响应数据校准了一种医生行为模型.
- 评估了假设的20%的激励活动价格上,通过预算中立性的其他活动的削减来资助,使用均分布等价的健康指标.
主要成果:
- 用三个场景说明了方法:糖尿病护理价格的变化,糖尿病和慢性阻塞性肺病护理,以及跨社会经济群体糖尿病患者的流感疫苗接种.
- 证明了卫生系统效率与社会经济健康不平等之间的权衡.
结论:
- 不平等厌恶可以整合到基于价值的定价策略中.
- 财政激励可以设计为积极影响健康在社会经济群体之间的分布.
- 该方法提供了一个框架,用于评估医疗补偿政策对公平的影响.
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