Alternative payment and care-delivery models in oncology: A systematic review.

Alternative payment and care-delivery models in oncology: A systematic review.
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DOI:
10.1002/cncr.31367
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发表时间:
2018-08
期刊:
影响因子:
6.2
通讯作者:
Korenstein D
Korenstein D
中科院分区:
医学1区
文献类型:
--
作者:
Aviki EM;Schleicher SM;Mullangi S;Matsoukas K;Korenstein D

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美国医疗保健成本的上升导致了替代支付和护理提供模式的创建,旨在通过报销和护理提供的变化来最大限度地提高结果和/或降低成本。这些干预措施对癌症护理的影响尚不清楚。我们进行了一项系统性综述,以描述癌症护理中新的替代支付和护理提供模式的情况。在这项系统性综述中,确定了癌症护理中的22种替代支付和/或护理提供模式。其中包括六个捆绑支付,四个负责任的护理组织,九个以病人为中心的医疗之家,以及其他三个干预措施。只有12项干预措施报告了结局;大多数(n=7,58%)改善了价值,4项没有影响,1项降低了价值,但仅在最初。结果的异质性排除了荟萃分析。尽管癌症的替代支付和交付模式有所增长,但评估其疗效的证据有限。
Rising US health care costs have lead to the creation of alternative payment and care delivery models designed to maximize outcomes and/or minimize costs through changes in reimbursement and care delivery. The impact of these interventions in cancer care is unclear. We performed a systematic review to describe the landscape of new alternative payment and care delivery models in cancer care. In this systematic review, 22 alternative payment and/or care delivery models in cancer care were identified. These included six bundled payments, four accountable care organizations, nine patient-centered medical homes, and three other interventions. Only 12 interventions reported outcomes; the majority (n=7, 58%) improved value, four had no impact, and one reduced value, but only initially. Heterogeneity of outcomes precluded a meta-analysis. Despite growth in alternative payment and delivery models in cancer, there is limited evidence to evaluate their efficacy.
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