Wan Thomas T H, Demachkie Masri Maysoun, Ortiz Judith, Lin Blossom Y J
Author Affiliations: College of Health and Public Affairs (Dr Wan), Department of Health Management and Informatics (Dr Masri), and Rural Health Research Group (Dr Ortiz), College of Health and Public Affairs, University of Central Florida, Orlando, Florida; and Department of Health Care Administration and Policy, China Medical University, Taichung, Taiwan (Dr Lin).
Health Care Manag (Frederick). 2014 Jan-Mar;33(1):64-74. doi: 10.1097/01.HCM.0000440625.92879.e8.
This study examines how health care managers responded to the accountable care organization (ACO). The effect of perceived benefits and barriers of the commitment to develop a strategic plan for ACOs and willingness to participate in ACOs is analyzed, using organizational social capital, health information technology uses, health systems integration and size of the health networks, geographic factors, and knowledge about ACOs as predictors. Propensity score matching and analysis are used to adjust the state and regional variations. When the number of perceived benefits is greater than the number of perceived barriers, health care managers are more likely to reveal a stronger commitment to develop a strategic plan for ACO adoption. Health care managers who perceived their organizations as lacking leadership support or commitment, financial incentives, and legal and regulatory support to ACO adoption were less willing to participate in ACOs in the future. Future research should gather more diverse views from a larger sample size of health professionals regarding ACO participation. The perspective of health care managers should be seriously considered in the adoption of an innovative health care delivery system. The transparency on policy formulation should consider multiple views of health care managers.
本研究考察了医疗保健管理人员对 accountable care organization（ACO，负责医疗组织）的应对方式。分析了对制定 ACO 战略计划的承诺所感知到的益处和障碍以及参与 ACO 的意愿的影响，使用组织社会资本、健康信息技术应用、医疗系统整合、医疗网络规模、地理因素以及对 ACO 的了解作为预测因素。倾向得分匹配和分析用于调整州和地区差异。当感知到的益处数量大于感知到的障碍数量时，医疗保健管理人员更有可能表现出对制定采用 ACO 的战略计划的更强承诺。那些认为其组织缺乏对采用 ACO 的领导支持或承诺、财务激励以及法律和监管支持的医疗保健管理人员未来参与 ACO 的意愿较低。未来的研究应该从更大样本量的医疗专业人员那里收集更多样化的关于参与 ACO 的观点。在采用创新的医疗保健提供系统时，应认真考虑医疗保健管理人员的观点。政策制定的透明度应考虑医疗保健管理人员的多种观点。
