Hospital management practices and medical device costs.
Hospital management practices and medical device costs.
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医院管理实践和医疗器械成本。
DOI：
10.1111/1475-6773.13898
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发表时间：
2022
影响因子：
3.4
通讯作者：
Swanson,Ashley
中科院分区：
文献类型：
--
作者：
Grennan,Matthew;Kim,GiHeung;McConnell,KJohn;Swanson,Ashley
目的确定心脏医疗设备价格的变化是否与心脏单位的管理实践有关。研究设置美国医院的心脏单位。研究设计我们回归了管理实践评分和其他医院特征的单位价格，有和没有设备固定效应的控制，数据收集已签订保密协议的可信第三方将去识别的医疗器械价格数据来自ECRI供应指南基准服务的N = 213家美国医院，以及关于这些医院心脏病房管理实践的调查答复;将合并后的数据提供给研究人员进行分析，并删除医院标识符。1980家拥有介入性心导管实验室且2010年至少有25例急性心肌梗死出院的医院符合条件，包容性; N= 648回答了管理实践调查;N= 213订阅了供应指南，并购买了至少11个顶级心脏医疗器械categories.Principal findingsCardiac units with better management practices paid lower prices for cardiac devices（管理评分增加一个标准差的价格下降百分比= 1.33%，95%置信区间0.99-1.67）。这是可比的幅度与一个标准差增加患者volume.ConclusionsBetter管理实践与较低的设备价格相关的价格下降。这种关系是稳固的，但幅度不大。不过，这种适度的幅度与其他预计会降低投入价格的事件类似，例如基准信息和医院合并形式的透明度。
ObjectiveTo determine whether the variation in prices paid for cardiac medical devices was associated with management practices in cardiac units.Study settingCardiac units in US hospitals.Study designWe regressed unit prices on management practice scores and other hospital characteristics, with and without controls for device fixed effects, for the 11 top‐spending cardiac device categories.Data collectionA trusted third party that had entered into a confidentiality agreement combined de‐identified medical device price data forN= 213 US hospitals from ECRI's Supply Guide benchmarking service, with survey responses regarding management practices in those hospitals' cardiac units; the resulting merged data were made available to researchers for analysis with hospital identifiers removed.N= 1980 hospitals with interventional cardiac catheterization laboratories and at least 25 annual acute myocardial infarction discharges in 2010 were eligible for inclusion;N= 648 responded to the management practices survey;N= 213 subscribed to Supply Guide and purchased at least one of 11 top cardiac medical device categories.Principal findingsCardiac units with better management practices paid lower prices for cardiac devices (percent decrease in price for one standard deviation increase in management score = 1.33%, 95% confidence interval 0.99–1.67). This was comparable in magnitude to the price decrease associated with a one standard deviation increase in patient volume.ConclusionsBetter management practices were associated with lower device prices. This relationship is robust, but modest in magnitude. This modest magnitude is similar, though, to other events expected to lower input prices, such as transparency in the form of benchmarking information and hospital mergers.