国家支出增长基准和医院收入,医院价格和保费
Christine Eibner1, Elizabeth C Chase1, Rose Kerber2
1RAND Corporation, Arlington, Virginia.
JAMA network open
|February 20, 2026
概括
医疗保健支出增长基准显示,几乎没有证据表明降低了成本. 国家可能需要更强有力的政策来有效控制支出.
科学领域:
- 卫生经济学 卫生经济学
- 卫生政策分析 卫生政策分析
- 医疗保健融资 医疗保健融资
背景情况:
- 自2013年以来,九个州实施了医疗保健支出增长基准,以控制成本.
- 各国根据这些基准来监测绩效,如果不遵守,可能会受到惩罚.
- 虽然增长往往超过基准,但这种方法可能会减缓与没有干预相比的支出.
研究的目的:
- 评估医疗保健支出增长基准和支出结果之间的关联.
- 评估国家一级基准政策对医疗保健成本的影响.
主要方法:
- 基于人群的病例控制研究,使用事件研究模型.
- 与未实施国家 (2015-2025) 的平衡比较器进行基准的州的医院和县的比较.
- 分析了医院的净收入,县级价格和市场溢价,使用CMS,RAND和CCIIO的数据.
主要成果:
- 平均而言,医院收入,价格或市场溢价没有出现统计学上显著的变化.
- 总共有4813家医院和3108个县被纳入分析.
- 罗德岛州显示,与基准相关的门诊价格在统计学上显著下降了55美元.
结论:
- 缺乏证据表明,医疗保健支出增长基准显著降低了医院的收入,价格或保费.
- 额外的政策或更严格的执法可能是必要的,以基准有意义地影响医疗保健支出.
- 该研究强调,需要强有力的政策设计来实现成本控制目标.
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