收费还是不收费:减少病人缺勤。

IF 3.5 4区 医学 Q1 HEALTH POLICY & SERVICES
Gideon Leibner, Shuli Brammli-Greenberg, Joseph Mendlovic, Avi Israeli
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引用次数: 1

摘要

背景:为了减少病人不来看病的情况,以色列政府正在推动立法,允许健康计划在预约预约时要求病人共同支付费用。希望这能激励病人提前取消预约,而不是干脆不来。这项政策的目标是改善病人获得医疗服务的机会,并确保有效利用医疗资源。我们探讨这一现象,以支持在这一问题上的循证决策,并确定拟议的立法是否与以往的研究结果一致。正文:逃诊率因国家和医疗保健服务而异,有几种策略可以缓解这一现象。有三个关键的利益相关者参与其中:(1)患者,(2)医务人员,(3)保险公司/管理的医疗机构,每个人都受到不同的影响,并面临不同的激励措施。在决定是否对失约者进行经济处罚时,应考虑多项因素,如罚款金额、服务类型、有效的罚款征收制度的建立、患者的社会经济地位以及加剧医疗保健机会差距的可能性。关于罚款对缺勤率影响的有限研究得出了好坏参半的结果。为了了解罚金数额对各种医疗保健服务的失诊率的影响,有必要进行进一步的调查。此外,重要的是要评估这一拟议的立法对患者行为的影响,获得医疗保健的机会,以及在获得的潜在差异。结论:预计拟议的立法对出勤率的影响微乎其微。为实现有意义的变革,应侧重于提高医疗服务的可得性,提高取消预约或处以巨额罚款的便利性。进一步的研究是必要的,以确定最有效的方法来解决病人的问题,并提高医疗保健系统的效率。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
To charge or not to charge: reducing patient no-show.

Background: In order to reduce patient no-show, the Israeli government is promoting legislation that will allow Health Plans to require a co-payment from patients when reserving an appointment. It is hoped that this will create an incentive for patients to cancel in advance rather than simply not show up. The goal of this policy is to improve patient access to medical care and ensure that healthcare resources are utilized effectively. We explore this phenomenon to support evidence-based decision making on this issue, and to determine whether the proposed legislation is aligned with the findings of previous studies.

Main body: No-show rates vary across countries and healthcare services, with several strategies in place to mitigate the phenomenon. There are three key stakeholders involved: (1) patients, (2) medical staff, and (3) insurers/managed care organizations, each of which is affected differently by no-shows and faces a different set of incentives. The decision whether to impose financial penalties for no-shows should take a number of considerations into account, such as the fine amount, service type, the establishment of an effective fine collection system, the patient's socioeconomic status, and the potential for exacerbating disparities in healthcare access. The limited research on the impact of fines on no-show rates has produced mixed results. Further investigation is necessary to understand the influence of fine amounts on no-show rates across various healthcare services. Additionally, it is important to evaluate the implications of this proposed legislation on patient behavior, access to healthcare, and potential disparities in access.

Conclusion: It is anticipated that the proposed legislation will have minimal impact on attendance rates. To achieve meaningful change, efforts should focus on enhancing medical service availability and improving the ease with which appointments can be cancelled or alternatively substantial fines should be imposed. Further research is imperative for determining the most effective way to address the issue of patient no-show and to enhance healthcare system efficiency.

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来源期刊
CiteScore
6.20
自引率
4.40%
发文量
38
审稿时长
28 weeks
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