自1980年以来,管理护理计划的绩效. 一个文学分析分析
1University of California-San Francisco, Institute for Health & Aging 94143.
JAMA
|May 18, 1994
概括
管理护理计划,如健康维护组织 (HMO),比赔偿计划更低的医院使用率和更高的预防服务使用率. 然而,参与者对服务的满意度较低,尽管对成本的满意度较高.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 相对有效性研究研究比较
- 卫生经济学 卫生经济学
背景情况:
- 自1980年以来,托管护理计划已经发生了显著的发展.
- 赔偿计划代表了医疗保险的传统方法.
- 对决策者和消费者来说,了解计划绩效的差异至关重要.
研究的目的:
- 为了比较医疗保健利用率,支出,护理质量,以及管理护理和赔偿计划之间的入学满意度.
- 综合各种管理护理模式的绩效证据.
主要方法:
- 从1980年开始的研究的系统文献综述.
- 将私人保险和医疗保险注册人员纳入比较组.
- 专注于同行评审的研究,并根据受访者特征进行统计调整.
主要成果:
- 与赔偿计划相比,健康维护组织 (HMO) 的住院率较低,住院时间较短.
- 医疗卫生组织表明,预防服务的使用增加,昂贵程序的使用减少.
- 在HMO中,受访者对服务的满意度较低,但对成本的满意度更高.
结论:
- 与赔偿计划相比,管理护理计划显示出不同的使用模式.
- 证据并不强烈支持特定的管理护理组织结构 (例如,员工模型与IPA模型) 的优越性.
- 一般化需要谨慎,因为选择偏差没有测量,计划结构不断变化和市场动态.
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