The effect of bundled payment on emergency department use: alternative quality contract effects after year one.
The effect of bundled payment on emergency department use: alternative quality contract effects after year one.
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DOI：
10.1111/acem.12205
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发表时间：
2013-09
期刊：
影响因子：
--
通讯作者：
Mark Fendrick A
中科院分区：
文献类型：
--
作者：
Sharp AL;Song Z;Safran DG;Chernew ME;Mark Fendrick A
确定替代质量合同（AQC）（马萨诸塞州蓝十字蓝盾（BCBS）于2009年实施的全球支付系统）对急诊科（艾德）利用率的影响。BCBS从2006年至2009年对332 624名注册者（其初级保健医生（PCP）参加了AQC）和1 296 399名注册者（其PCP未参加AQC）进行了评估。我们使用了一种前后干预控制倾向评分差异的方法来隔离AQC对艾德利用的影响。该分析调整了年龄、性别、健康状况和长期趋势，以比较治疗组和对照组之间的艾德利用率。总体而言，长期趋势显示治疗组和对照组的艾德利用率均略有下降。AQC组的调整分析显示，每位成员/季度的访问量从0.131减少到0.127，对照组从0.157减少到0.152。差异中差异分析显示，与对照组相比，AQC对总艾德利用率无统计学显著影响。在第一年，AQC对艾德利用率没有显著影响。类似的全球预算方案可能不会改变最初实施期间艾德的使用。
Identify the effect of the Alternative Quality Contract (AQC), a global payment system implemented by Blue Cross Blue Shield of Massachusetts (BCBS) in 2009, on emergency department (ED) utilization. BCBS claims from 2006–2009 for 332,624 enrollees whose primary care physician (PCP) enrolled in the AQC, and 1,296,399 whose PCP was not enrolled in the AQC were evaluated. We used a pre-post, intervention-control, propensity scored difference-in-difference approach to isolate the AQC effect on ED utilization. The analysis adjusted for age, sex, health status and secular trends to compare ED utilization between the treatment and control groups. Overall, secular trends showed ED utilization decreased slightly for both treatment and control groups. The adjusted analysis of the AQC group showed decreases from 0.131 to 0.127 visits per member/quarter, and the control group decreased from 0.157 to 0.152 visits per member/quarter. The difference-in-difference analysis showed the AQC had no statistically significant effect on total ED utilization compared to the control group. In its first year, the AQC had no significant effect on ED utilization. Similar global budget programs may not alter ED use in the initial implementation period.
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DOI：
10.1377/hlthaff.2012.0327
发表时间：
2012-08
期刊：
Health affairs (Project Hope)
影响因子：
--
作者：
Song Z;Safran DG;Landon BE;Landrum MB;He Y;Mechanic RE;Day MP;Chernew ME
通讯作者：
Chernew ME
影响因子：
158.5
作者：
Song, Zirui;Safran, Dana Gelb;Chernew, Michael E.
通讯作者：
Chernew, Michael E.
影响因子：
9.7
作者：
Miller, Harold D.
通讯作者：
Miller, Harold D.
影响因子：
9.7
作者：
Goldsmith, Jeff
通讯作者：
Goldsmith, Jeff
影响因子：
6.1
作者：
WHITE, H
通讯作者：
WHITE, H