使用患者报告的结果措施支付健康收益
Luigi Siciliani1, James Gaughan2, Nils Gutacker2
1Department of Economics and Related Studies, and Centre for Health Economics, University of York, York, UK.
按绩效支付的模式奖励医疗保健提供者为患者的健康结果. 一个合同理论的方法表明,最佳奖金应该反映医疗改善的提供者成本的变化,特别是对于诸如关节和膝关节置换等手术.
科学领域:
- 卫生经济学 卫生经济学
- 医疗保健支付模式 医疗保健支付模式
- 合同理论在医疗保健中的应用
背景情况:
- 传统的医疗保健支付往往侧重于服务量,而不是患者的结果.
- 这可能会导致效率低下和低于最佳的患者护理.
- 绩效支付 (P4P) 是一种替代性报销模式,奖励改善的健康结果.
研究的目的:
- 应用合同理论来为P4P计划的实际实施提供信息.
- 制定一个定价规则,以确定最佳的基于绩效的奖金.
- 为了估计关节和膝盖置换手术的最佳奖金.
主要方法:
- 利用合同理论框架来建模医疗保健提供者的激励措施.
- 根据边际成本推导出基于绩效奖金的定价规则.
- 根据各种假设,对于关节和膝关节置换,估计的最佳奖金支付.
主要成果:
- 拟议的定价规则建议奖金应等于干预前后改善健康的边际成本差异.
- 最佳的奖金水平对提供者成本结构和购买者对健康的估值都很敏感.
- 在关节和膝关节置换手术中提供最佳奖金的估计.
结论:
- 合同理论为设计有效的P4P计划提供了一个强大的框架.
- 最佳设置的奖金可以激励提供者实现所需的健康结果.
- 这些发现对医疗保健支付改革和基于价值的护理计划有影响.
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