Estimating the Costs of Supporting Primary Care Practice Transformation

估算支持初级保健实践转型的成本

基本信息

  • 批准号:
    8628313
  • 负责人:
  • 金额:
    $ 10万
  • 依托单位:
  • 依托单位国家:
    美国
  • 项目类别:
  • 财政年份:
    2013
  • 资助国家:
    美国
  • 起止时间:
    2013-09-30 至 2015-09-29
  • 项目状态:
    已结题

项目摘要

DESCRIPTION (provided by applicant): We apply for funding for an R03 study in response to AHRQ's RFA-HS-13-003, Estimating the Costs of Supporting Primary Care Practice Transformation. While a growing evidence base is documenting the quantifiable impact of primary care transformation, the cost of implementing these transformations remains relatively unknown. The Palo Alto Medical Foundation (PAMF) is a non-profit multispecialty group practice in Northern California. Three characteristics of PAMF make it an ideal setting to estimate the costs associated with transformational primary care initiatives. First, PAMF has been successfully re-designing primary care delivery, with evidence of quality improvements, since 2000 and ten PAMF clinics have been recognized by the National Committee on Quality Assurance as Patient Centered Medical Homes. Second, being a large multispecialty practice with a multitude of payers and having physicians whose compensation reflects fee-for- service incentives make lessons from PAMF applicable to a wide range of health care delivery settings. Third, the proposed study will expand upon previous work funded under AHRQ's "Transforming Primary Care" FOA (R18 HS019167-01, P.I. Tai-Seale) and will leverage extensive knowledge about the transformation of PAMF practices, ongoing research about the impact of the transformation on quality improvements, and a network of supportive and engaged PAMF leaders, clinicians and staff. The proposed project will follow an "activity-based costing" approach to determine the costs of implementing key primary care initiatives, including but not limited to Shared Medical Appointments, Team Care for patients with chronic illnesses, and Automatic Lab Ordering via a Patient Health Record System, from the perspective of PAMF. The specific aims are to: (1) Identify the key components of the transformation process and sources of direct and indirect costs. Indirect costs involving human resources will be analyzed according to what tasks or "activities" were completed, which personnel were involved in each activity, and how much time was spent on each activity. In-depth key informant interviews with stakeholders from different levels of the organization and clinics of varying sizes will be triangulated with archival (e-mail messages, calendar appointments, meeting minutes) and quantitative data obtained from the access log in the electronic health records, employee time project codes, and payroll data; and (2) Determine the costs of the key components we identify. All costs will be priced at national market averages, and national salary data will be used to determine the costs of employee time spent on each activity. The costs will be analyzed at multiple levels: physician, clinic, division, and the organization, with a subgroup analysis of clinics serving minority and underserved patients. 1
描述(由申请人提供):我们申请资助一项R03研究,以响应AHRQ的RFA-HS-13-003,估计支持初级保健实践转型的成本。虽然越来越多的证据基础正在记录初级保健转型的可量化影响,但实施这些转型的成本仍然相对未知。帕洛阿尔托医学基金会(PAMF)是一个非营利性的多专业团体实践在北加州。PAMF的三个特征使其成为估算与转型初级保健倡议相关的成本的理想环境。首先,自2000年以来,PAMF已经成功地重新设计了初级保健服务,有证据表明质量有所提高,10家PAMF诊所已被国家质量保证委员会认可为以患者为中心的医疗之家。其次,作为一个拥有众多支付者的大型多专业实践,以及医生的薪酬反映了按服务收费的激励机制,使得PAMF的经验教训适用于广泛的医疗保健服务环境。第三,拟议的研究将扩展AHRQ“初级保健转型”FOA (R18 HS019167-01, P.I. taiseale)资助的先前工作,并将利用关于PAMF实践转型的广泛知识,关于转型对质量改进的影响的正在进行的研究,以及支持和参与PAMF领导人,临床医生和员工的网络。从PAMF的角度来看,拟议的项目将遵循“基于活动的成本计算”方法来确定实施关键初级保健计划的成本,包括但不限于共享医疗预约、慢性病患者的团队护理和通过患者健康记录系统自动订购实验室。具体目标是:(1)确定转型过程的关键组成部分以及直接和间接成本的来源。涉及人力资源的间接成本将根据完成了哪些任务或“活动”,哪些人员参与了每项活动,以及每项活动花费了多少时间来分析。与来自不同级别的组织和不同规模的诊所的利益相关者进行深入的关键信息提供者访谈将与档案(电子邮件消息、日历预约、会议纪要)和从电子健康记录的访问日志中获得的定量数据、员工时间项目代码和工资单数据进行三角测量;(2)确定我们确定的关键部件的成本。所有费用将按全国市场平均价格定价,并将使用全国工资数据来确定雇员在每项活动上花费的时间成本。成本将在多个层面进行分析:医生、诊所、部门和组织,并对服务少数族裔和服务不足患者的诊所进行亚组分析。1

项目成果

期刊论文数量(3)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
Estimating the Human Resource Costs of Developing and Implementing Shared Medical Appointments in Primary Care.
估计初级保健中开发和实施共享医疗预约的人力资源成本。
  • DOI:
    10.1097/jac.0000000000000084
  • 发表时间:
    2016
  • 期刊:
  • 影响因子:
    0
  • 作者:
    Stults,CherylD;McClellan,Sean;Panattoni,Laura;Mazza,MaryCarol;Tai-Seale,Ming
  • 通讯作者:
    Tai-Seale,Ming
Cost Estimates for Designing and Implementing a Novel Team Care Model for Chronically Ill Patients.
为慢性病患者设计和实施新型团队护理模式的成本估算。
  • DOI:
    10.1097/jac.0000000000000209
  • 发表时间:
    2018
  • 期刊:
  • 影响因子:
    0
  • 作者:
    Panattoni,Laura;Dillon,Ellis;Hurlimann,Lily;Durbin,Meg;Tai-Seale,Ming
  • 通讯作者:
    Tai-Seale,Ming
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MING TAI-SEALE其他文献

MING TAI-SEALE的其他文献

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{{ truncateString('MING TAI-SEALE', 18)}}的其他基金

Primary Care Transformation in a NCQA Certified Patient-Centered Medical Home
NCQA 认证的以患者为中心的医疗之家的初级保健转型
  • 批准号:
    8123369
  • 财政年份:
    2010
  • 资助金额:
    $ 10万
  • 项目类别:
Mental Health Communication in Elderly Primary Care Visits and Economic Outcomes
老年人初级保健就诊和经济成果中的心理健康沟通
  • 批准号:
    8103654
  • 财政年份:
    2010
  • 资助金额:
    $ 10万
  • 项目类别:
Primary Care Transformation in a NCQA Certified Patient-Centered Medical Home
NCQA 认证的以患者为中心的医疗之家的初级保健转型
  • 批准号:
    7992339
  • 财政年份:
    2010
  • 资助金额:
    $ 10万
  • 项目类别:
A Study of Trends in Obesity Progression among Complex Patients
复杂患者肥胖进展趋势的研究
  • 批准号:
    8015851
  • 财政年份:
    2010
  • 资助金额:
    $ 10万
  • 项目类别:
Mental Health Communication in Elderly Primary Care Visits and Economic Outcomes
老年人初级保健就诊和经济成果中的心理健康沟通
  • 批准号:
    7595412
  • 财政年份:
    2009
  • 资助金额:
    $ 10万
  • 项目类别:
Economic Analysis of Depression Treatment Process
抑郁症治疗过程的经济分析
  • 批准号:
    6653890
  • 财政年份:
    2002
  • 资助金额:
    $ 10万
  • 项目类别:
Economic Analysis of Depression Treatment Process
抑郁症治疗过程的经济分析
  • 批准号:
    6940660
  • 财政年份:
    2002
  • 资助金额:
    $ 10万
  • 项目类别:
Economic Analysis of Depression Treatment Process
抑郁症治疗过程的经济分析
  • 批准号:
    7120054
  • 财政年份:
    2002
  • 资助金额:
    $ 10万
  • 项目类别:
Economic Analysis of Depression Treatment Process
抑郁症治疗过程的经济分析
  • 批准号:
    6793547
  • 财政年份:
    2002
  • 资助金额:
    $ 10万
  • 项目类别:
Economic Analysis of Depression Treatment Process
抑郁症治疗过程的经济分析
  • 批准号:
    6543546
  • 财政年份:
    2002
  • 资助金额:
    $ 10万
  • 项目类别:

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