增加初级保健团队小组规模是否会影响医疗保健成本:VHA试点计划的调查结果
Edwin S Wong1, Leslie L Taylor2, Jorge Rojas2
1Center of Innovation for Veteran-Centered and Value-Driven Care, VA Puget Sound Health Care System, 1660 S. Columbian Way, MS-152, Seattle, WA, 98108, USA; Department of Health Systems and Population Health, University of Washington, 3980 15th Ave. NE, Seattle, WA, 98195, USA; Primary Care Analytics Team (PCAT), VA Puget Sound Health Care System, 1660 S. Columbian Way, MS-152, Seattle, WA, 98108, USA.
增加退伍军人卫生管理局 (VHA) 患者医疗团队 (PACT) 面板规模并没有增加患者的整体医疗成本. 这一发现支持卫生领导者优化初级保健提供人员和小组规模.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 初级保健管理管理初级保健管理
- 医疗保健经济学 医疗保健经济学
背景情况:
- 退伍军人卫生管理局 (VHA) 使用患者协调护理团队 (PACT) 提供初级保健.
- 在初级保健中面临的员工挑战促使人们探索增加团队小组规模.
研究的目的:
- 评估 PACT 团队小组规模的扩大是否会影响整体医疗成本.
- 确定VHA内部替代初级保健人员模型的成本效益.
主要方法:
- 一个准实验性设计比较了标准与扩展面板大小的PACT团队的前后成本变化.
- 分析了来自VHA的企业数据仓库和管理成本会计系统的数据.
- 调整为患者人口统计学,并发症和零成本观察的两部分建模.
主要成果:
- 扩大PACT小组规模并没有导致总医疗费用在统计上显著增加.
- 在各医疗中心,VHA提供的护理费用保持不变.
- 在一个地点观察到合同护理成本的下降.
结论:
- 增加PACT团队小组规模超出VHA的标准水平并不会提高患者一级的医疗成本.
- 调查结果可以为卫生系统领导人提供适当的小组规模和人员配置策略的信息.
- 这项研究支持高效的初级保健资源分配.
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