全连续过程中的问责制:亚急性护理提供者在问责制医疗组织中的参与情况。
Accountability across the Continuum: The Participation of Postacute Care Providers in Accountable Care Organizations.
作者信息
Colla Carrie H, Lewis Valerie A, Bergquist Savannah L, Shortell Stephen M
机构信息
The Dartmouth Institute for Health Policy & Clinical Practice, Geisel School of Medicine, Lebanon, NH.
Department of Health Care Policy, Harvard Medical School, Boston, MA.
出版信息
Health Serv Res. 2016 Aug;51(4):1595-611. doi: 10.1111/1475-6773.12442. Epub 2016 Jan 22.
OBJECTIVE
To examine the extent to which accountable care organizations (ACOs) formally incorporate postacute care providers.
DATA SOURCES
The National Survey of ACOs (N = 269, response rate 66 percent).
STUDY DESIGN
We report statistics on ACOs' formal inclusion of postacute care providers and the organizational characteristics and clinical capabilities of ACOs that have postacute care.
PRINCIPAL FINDINGS
Half of ACOs formally include at least one postacute service, with inclusion at higher rates in ACOs with commercial (64 percent) and Medicaid contracts (70 percent) compared to ACOs with Medicare contracts only (45 percent). ACOs that have a formal relationship with a postacute provider are more likely to have advanced transition management, end of life planning, readmission prevention, and care management capabilities.
CONCLUSIONS
Many ACOs have not formally engaged postacute care, which may leave room to improve service integration and care management.
目的
探讨 accountable care organizations(ACO)正式纳入急性后期护理服务提供者的程度。
数据来源
ACO 全国调查(N = 269,回复率 66%)。
研究设计
我们报告有关 ACO 正式纳入急性后期护理服务提供者的统计数据,以及有急性后期护理服务的 ACO 的组织特征和临床能力。
主要发现
一半的 ACO 正式纳入了至少一项急性后期护理服务,与仅签订医疗保险合同的 ACO(45%)相比,签订商业保险合同(64%)和医疗补助合同(70%)的 ACO 纳入比例更高。与急性后期护理服务提供者建立正式关系的 ACO 更有可能具备先进的过渡管理、临终规划、再入院预防和护理管理能力。
结论
许多 ACO 尚未正式参与急性后期护理,这可能为改善服务整合和护理管理留出空间。
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