Holden Debra J, Reiter Kristin, O'Brien Donna, Dalton Kathleen
RTI International, 3040 E Cornwallis Rd, PO Box 12194, Research Triangle Park, NC, 27709, USA.
Department of Health Policy and Management, The University of North Carolina, Chapel Hill, NC, 27599, USA.
Health Res Policy Syst. 2015 Oct 14;13:44. doi: 10.1186/s12961-015-0031-x.
In 2007, the National Cancer Institute (NCI) launched the NCI Community Cancer Centers Program (NCCCP) as a public-private partnership with community hospitals with a goal of advancing cancer care and research. In order to leverage federal dollars in a time of limited resources, matching funds from each participating hospital were required. The purpose of this paper is to examine hospitals' level of and rationale for co-investment in this partnership, and whether there is an association between hospitals' co-investment and achievement of strategic goals.
Analysis using a comparative case study and micro-cost data was conducted as part of a comprehensive evaluation of the NCCCP pilot to determine the level of co-investment made in support of NCI's goals. In-person or telephone interviews with key informants were conducted at 10 participating hospital and system sites during the first and final years of implementation. Micro-cost data were collected annually from each site from 2007 to 2010. Self-reported data from each awardee are presented on patient volume and physician counts, while secondary data are used to examine the local Medicare market share.
The rationale expressed by interviewees for participation in a public-private partnership with NCI included expectations of increased market share, higher patient volumes, and enhanced opportunities for cancer physician recruitment as a result of affiliation with the NCI. On average, hospitals invested resources into the NCCCP at a level exceeding $3 for every $1 of federal funds. Six sites experienced a statistically significant change in their Medicare market share. Cancer patient volume increased by as much as one-third from Year 1 to Year 3 for eight of the sites. Nine sites reported an increase in key cancer physician recruitment.
Demonstrated investments in cancer care and research were associated with increases in cancer patient volume and perhaps in recruitment of key cancer physicians, but not in increased Medicare market share. Although the results reflect a small sample of hospitals, findings suggest that hospital executives believe there to be a strategic case for a public-private partnership as demonstrated through the NCCCP, which leveraged federal funds to support mutual goals for advancing cancer care and research.
2007年，美国国立癌症研究所（NCI）启动了NCI社区癌症中心项目（NCCCP），作为与社区医院的公私合作项目，目标是推进癌症护理和研究。为了在资源有限的时期充分利用联邦资金，要求每家参与医院提供配套资金。本文旨在研究医院在该合作项目中的共同投资水平及理由，以及医院的共同投资与战略目标的实现之间是否存在关联。
作为对NCCCP试点项目全面评估的一部分，采用比较案例研究和微观成本数据进行分析，以确定为支持NCI目标而进行的共同投资水平。在实施的第一年和最后一年，对10个参与医院和系统站点的关键信息提供者进行了面对面或电话访谈。2007年至2010年期间，每年从每个站点收集微观成本数据。每个获奖者的自我报告数据包括患者数量和医生人数，同时使用二手数据来研究当地医疗保险市场份额。
受访者表示参与与NCI的公私合作项目的理由包括期望通过与NCI的合作增加市场份额、提高患者数量以及增加招聘癌症医生的机会。平均而言，医院投入到NCCCP的资源水平为每1美元联邦资金对应超过3美元。六个站点的医疗保险市场份额发生了统计学上的显著变化。八个站点的癌症患者数量从第1年到第3年增加了多达三分之一。九个站点报告关键癌症医生的招聘有所增加。
在癌症护理和研究方面的实际投资与癌症患者数量的增加以及可能关键癌症医生的招聘增加有关，但与医疗保险市场份额的增加无关。尽管结果反映的是一小部分医院的情况，但研究结果表明，医院管理人员认为通过NCCCP展示了公私合作项目的战略意义，该项目利用联邦资金来支持推进癌症护理和研究的共同目标。
