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美国卫生系统中的糖尿病护理融资:解决医疗和社会健康决定因素的支付创新。

Financing Diabetes Care in the U.S. Health System: Payment Innovations for Addressing the Medical and Social Determinants of Health.

机构信息

Department of Public Health Sciences, The University of Chicago, 5841 S. Maryland Ave., MC 2000, Chicago, IL, 60637, USA.

Chicago Center for Diabetes Translation Research, The University of Chicago, Chicago, IL, USA.

出版信息

Curr Diab Rep. 2019 Nov 20;19(11):136. doi: 10.1007/s11892-019-1275-6.

Abstract

PURPOSE OF REVIEW

Review innovations in health care financing promoting health system investments in addressing medical and social determinants of health (SDH) for patients with diabetes.

RECENT FINDINGS

Particular payment models implemented in the public and private sectors increasingly offer flexibility in health care organizations (HCOs) to allocate resources towards helping patients with diabetes overcome the medical and socio-economic problems driving poor population and individual health. The barriers imposed by the traditional fee-for-service (FFS) payment model to incorporating SDH into health care delivery across the health system are being overcome with new payment approaches rewarding the quality of care provided rather than strictly the volume of health services rendered. Evidence suggests health care financing changes will facilitate the realization of health reform goals to provide the right care to the right people at the right time through the expansion of the role of integrated care teams that can address patients' medical and health-related social needs.

摘要

目的综述:综述促进医疗体系投资以解决医疗和社会决定因素(SDH),从而改善糖尿病患者健康的医保融资创新。

发现:公共和私营部门实施的特定支付模式为医疗保健组织(HCO)提供了更大的灵活性,以便将资源用于帮助糖尿病患者克服导致人群和个人健康状况不佳的医疗和社会经济问题。新的支付方式正在克服传统按服务项目付费(FFS)模式将 SDH 纳入整个医疗体系医疗服务提供的障碍,这些新方式奖励的是所提供医疗服务的质量,而不仅仅是服务量。有证据表明,医保融资改革将促进实现卫生改革目标,通过扩大能够解决患者医疗和相关社会需求的综合护理团队的作用,在正确的时间为正确的人提供正确的护理。

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