...
  • 主题
高级搜索  >
历史搜索 清空历史
首页> 外文期刊>Journal of health economics >System-wide impacts of hospital payment reforms: Evidence from Central and Eastern Europe and Central Asia
【24h】

System-wide impacts of hospital payment reforms: Evidence from Central and Eastern Europe and Central Asia

机译：医院支付改革对全系统的影响：来自中东欧和中亚的证据

获取原文
获取原文并翻译 | 示例
   

获取外文期刊封面封底 >>

       
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

While there is broad agreement that the way that health care providers are paid affects their performance, the empirical literature on the impacts of provider payment reforms is surprisingly thin. During the 1990s and early 2000s, many European and Central Asian (ECA) countries shifted from paying hospitals through historical budgets to fee-for-service (FFS) or patient-based payment (PBP) methods (mostly variants of diagnosis-related groups, or DRGs). Using panel data on 28 countries over the period 1990-2004, we exploit the phased shift from historical budgets to explore aggregate impacts on hospital throughput, national health spending, and mortality from causes amenable to medical care. We use a regression version of difference-in-differences (DID) and two variants that relax the DID parallel trends assumption. We find that FFS and PBP both increased national health spending, including private (i.e. out-of-pocket) spending. However, they had different effects on inpatient admissions (FFS increased them; PBP had no effect), and average length of stay (FFS had no effect; PBP reduced it). Of the two methods, only PBP appears to have had any beneficial effect on "amenable mortality", but we found significant impacts for only a couple of causes of death, and not in all model specifications.
机译：尽管人们普遍认为医疗保健提供者的付款方式会影响其绩效，但有关提供者付款改革影响的经验文献却令人惊讶地薄。在1990年代和2000年代初期，许多欧洲和中亚（ECA）国家从通过历史预算的医院付款方式转变为按服务付费（FFS）或基于患者的付款（PBP）方法（主要是诊断相关群体的变体，或DRG）。我们使用1990年至2004年期间28个国家/地区的面板数据，采用了从历史预算的阶段性转变，以探讨对医院吞吐量，国民医疗保健支出以及因医疗原因引起的死亡率的总体影响。我们使用差异差异（DID）和两个变量的回归版本，这些变量放宽了DID平行趋势假设。我们发现FFS和PBP都增加了国家卫生支出，包括私人（即自付费用）支出。但是，它们对住院病人的影响不同（FFS增加了他们的影响； PBP没有影响）和平均住院时间（FFS没有影响； PBP减少了它）。在这两种方法中，只有PBP似乎对“适当的死亡率”有任何有益的影响，但是我们发现仅对几个死因产生了显着影响，而并非在所有模型规格中都产生了显着影响。

著录项

相似文献

  • 外文文献
  • 中文文献
  • 专利
获取原文

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号