Spillover effects of financial incentives for providers onto non-targeted patients: daycase surgery in English hospitals.
Spillover effects of financial incentives for providers onto non-targeted patients: daycase surgery in English hospitals.
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提供者经济激励对非目标患者的溢出效应：英国医院的日间手术。
DOI：
10.1017/s1744133123000063
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发表时间：
2023
期刊：
影响因子：
--
通讯作者：
Britteon P
中科院分区：
文献类型：
--
作者：
Britteon P
背景：对医疗保健提供者的激励也可能影响非目标患者。这些溢出效应对激励方案的充分影响和评价具有重要意义。然而，关于这种溢出效应在卫生保健领域的程度的研究很少。我们调查了作为日间病例进行外科手术的动机是否会影响相同专业的其他选择性手术是否也被视为日间病例。数据：2016年4月至3月期间，英格兰127家医院信托机构的8,505,754名患者接受了92项非目标手术。方法中断时间序列分析6个目标患者同时接受治疗的专科和3个未接受治疗的专科的非目标患者作为日间病例治疗的概率。结果：在受激励的专科接受非靶向手术的患者，日病例率最初增加（1.04个百分点，SE: 0.30），但随着时间的推移，日病例率下降。相反，在非激励专业治疗的患者，日病例率随着时间的推移逐渐下降。财政激励的溢出效应对不同的活动和时间有不同的影响。政策制定者和研究人员应该在设计和评估激励方案时考虑溢出效应的可能性。
Background Incentives for healthcare providers may also affect non-targeted patients. These spillover effects have important implications for the full impact and evaluation of incentive schemes. However, there are few studies on the extent of such spillovers in health care. We investigated whether incentives to perform surgical procedures as daycases affected whether other elective procedures in the same specialties were also treated as daycases. Data 8,505,754 patients treated for 92 non-targeted procedures in 127 hospital trusts in England between April and March 2016. Methods Interrupted time series analysis of the probability of being treated as a daycase for non-targeted patients treated in six specialties where targeted patients were also treated and three specialties where they were not. Results The daycase rate initially increased (1.04 percentage points, SE: 0.30) for patients undergoing a non-targeted procedure in incentivised specialties but then reduced over time. Conversely, the daycase rate gradually decreased over time for patients treated in a non-incentivised specialty. Discussion Spillovers from financial incentives have variable effects over different activities and over time. Policymakers and researchers should consider the possibility of spillovers in the design and evaluation of incentive schemes.
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DOI：
10.1177/1077558719856775
发表时间：
2020-12
期刊：
Medical care research and review : MCRR
影响因子：
--
作者：
Cattel D;Eijkenaar F
通讯作者：
Eijkenaar F
影响因子：
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作者：
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影响因子：
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作者：
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DOI：
--
发表时间：
2018
期刊：
Oxford Research Encyclopedia of Economics and Finance
影响因子：
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作者：
M. Chalkley
通讯作者：
M. Chalkley
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DOI：
--
发表时间：
2015
期刊：
影响因子：
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作者：
Karli K. Kondo;C. Damberg;Aaron Mendelson;M. Motu’apuaka;M. Freeman;M. O’Neil;R. Relevo;D. Kansagara
通讯作者：
D. Kansagara