质量的商业案例:在基于价值的采购模式中估算挽救的生命和避免的伤害。

Health affairs scholar Pub Date : 2024-04-30 eCollection Date: 2024-05-01 DOI:10.1093/haschl/qxae052
Peter Amico, Elizabeth E Drye, Peter Lee, Carolee Lantigua, Dana Gelb Safran
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引用次数: 0

摘要

人们对质量评估和报告的成本和负担日益关注,这就提出了一个问题:患者能从医疗服务提供者激励绩效改进的安排中获益多少?我们利用国家绩效数据估算了如果美国医疗计划在血压控制和结肠直肠癌筛查这两项广泛使用的质量衡量标准上提高绩效,将在挽救生命和避免伤害方面带来的益处。我们对加利福尼亚州市场计划的潜在结果进行了建模,在该计划中,一项基于价值的购买倡议激励改进工作,我们还对美国 4 个细分市场(医疗保险、医疗补助、市场计划、商业计划)的人口进行了建模。结果表明,如果表现较差的医疗计划的基准分数提高到第 66 位,那么每年的高血压和结直肠癌死亡人数将分别减少约 7% 和 2%。这些分析凸显了评估绩效问责倡议的价值,即评估其可能挽救的生命和避免的伤害,以及其成本和努力。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The business case for quality: estimating lives saved and harms avoided in a value-based purchasing model.

Ever-increasing concern about the cost and burden of quality measurement and reporting raises the question: How much do patients benefit from provider arrangements that incentivize performance improvements? We used national performance data to estimate the benefits in terms of lives saved and harms avoided if US health plans improved performance on 2 widely used quality measures: blood pressure control and colorectal cancer screening. We modeled potential results both in California Marketplace plans, where a value-based purchasing initiative incentivizes improvement, and for the US population across 4 market segments (Medicare, Medicaid, Marketplace, commercial). The results indicate that if the lower-performing health plans improve to 66th percentile benchmark scores, it would decrease annual hypertension and colorectal cancer deaths by approximately 7% and 2%, respectively. These analyses highlight the value of assessing performance accountability initiatives for their potential lives saved and harms avoided, as well as their costs and efforts.

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