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首页> 外文期刊>Journal of Health Services Research & Policy >Assessing the value of hospital-in-the-home: lessons from Australia
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Assessing the value of hospital-in-the-home: lessons from Australia

机译：评估家庭医院的价值：澳大利亚的经验教训

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Objectives: To identify factors that in uence the cost-effectiveness of hospital-in-the-home (HITH) and to discussnthe impact of funding arrangements in creating incentives or disincentives for the establishment of HITH services.nMethods: A review of HITH services in Australia was undertaken. Based on the review, factors affecting the relativencosts of HITH and conventional care were identi. ed, in particular, the effect of funding and organisationalnarrangements on the incentives for managers and providers to choose between HITH and conventional care.nResults: The review of HITH services identi. ed a wide range of models of HITH in Australia. Factors identi. ed asnimportant to the success of HITH included demographic and location issues, referral mechanisms, the choice ofnstaf. ng and the management of the programme. However, it was clear that the structure of the programme oftennrelated to funding arrangements. Issues such as ‘incentive funding’, establishment costs and opportunity for costshiftingnwere identi. ed as being relevant to incentives for the ef. cient provision of HITH.nConclusions: Evaluations are essential to inform decisions about whether HITH is likely to be a viable and costeffectivenalternative to inpatient care. However, the relative costs of HITH and conventional care will depend onnlocal factors. From the point of view of the decision-maker, these will be affected by funding and organisationalnarrangements. Funders must be aware that complex . nancial incentives may mask the true costs of HITH servicesnrelative to hospital services. They need to ensure that the incentives created by funding arrangements arentransparent.
机译：目标：确定影响在家中医院（HITH）成本效益的因素，并讨论资金安排对建立HITH服务的激励措施或激励措施的影响。n方法：对HITH服务进行回顾在澳大利亚进行。在此基础上，确定了影响HITH和传统护理相对成本的因素。特别是，资金和组织安排对管理者和提供者在HITH和常规护理之间进行选择的动机的影响。n结果：对HITH服务身份的审查。在澳大利亚编辑了各种各样的HITH型号。因素识别。对HITH的成功至关重要的内容包括人口统计和位置问题，推荐机制以及对nstaf的选择。 ng和计划的管理。但是，很明显，该方案的结构通常与供资安排无关。诸如“激励资金”，机构成本和成本转移机会等问题尚未明确。 ed与对ef的激励有关。结论：评估对于决定HITH是否可能成为住院治疗的可行且具有成本效益的替代方案至关重要。但是，HITH和常规护理的相对费用将取决于局部因素。从决策者的角度来看，这些将受到资金和组织安排的影响。资助者必须意识到这一点。财政激励措施可能会掩盖相对于医院服务而言的HITH服务的真实成本。他们需要确保资金安排产生的激励措施是不透明的。

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