报销制度对病人护理的影响--系统综述的系统综述。

IF 2.7 3区 经济学 Q1 ECONOMICS
Eva Wagenschieber, Dominik Blunck
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引用次数: 0

摘要

背景:目前还没有足够的科学证据来回答不同的报销制度对病人护理和治疗质量有多大影响的问题。由于医生、医疗保险公司和患者之间的信息不对称,因此有必要建立基于市场的机制,以确保为患者提供最好的医疗服务。本研究旨在从结构、过程和结果指标等方面探讨报销制度如何影响患者护理的多个领域:为此,我们在 PubMed、Web of Science 和 Cochrane Library 等数据库中进行了系统的文献综述。对工资、捆绑支付、按服务收费和基于价值的报销制度进行了研究。根据结构、过程和结果三个维度对患者护理进行划分,并分八个子类别进行评估:结果:本文共收录了 34 篇综述,涉及 971 项基础研究。国际研究发现,资源利用率和质量/健康结果类别的影响最大。按绩效付费和捆绑付费是最常见的研究模式。在所研究的系统中,按服务收费和以价值为基础的报销系统对患者护理的影响最为积极:结论:报销制度的选择会对患者护理产生影响。今后的研究需要进一步探讨成功实施的因素。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Impact of reimbursement systems on patient care - a systematic review of systematic reviews.

Background: There is not yet sufficient scientific evidence to answer the question of the extent to which different reimbursement systems influence patient care and treatment quality. Due to the asymmetry of information between physicians, health insurers and patients, market-based mechanisms are necessary to ensure the best possible patient care. The aim of this study is to investigate how reimbursement systems influence multiple areas of patient care in form of structure, process and outcome indicators.

Methods: For this purpose, a systematic literature review of systematic reviews is conducted in the databases PubMed, Web of Science and the Cochrane Library. The reimbursement systems of salary, bundled payment, fee-for-service and value-based reimbursement are examined. Patient care is divided according to the three dimensions of structure, process, and outcome and evaluated in eight subcategories.

Results: A total of 34 reviews of 971 underlying primary studies are included in this article. International studies identified the greatest effects in categories resource utilization and quality/health outcomes. Pay-for-performance and bundled payments were the most commonly studied models. Among the systems examined, fee-for-service and value-based reimbursement systems have the most positive impact on patient care.

Conclusion: Patient care can be influenced by the choice of reimbursement system. The factors for successful implementation need to be further explored in future research.

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来源期刊
CiteScore
3.90
自引率
4.20%
发文量
59
审稿时长
13 weeks
期刊介绍: Health Economics Review is an international high-quality journal covering all fields of Health Economics. A broad range of theoretical contributions, empirical studies and analyses of health policy with a health economic focus will be considered for publication. Its scope includes macro- and microeconomics of health care financing, health insurance and reimbursement as well as health economic evaluation, health services research and health policy analysis. Further research topics are the individual and institutional aspects of health care management and the growing importance of health care in developing countries.
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