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新绩效信息在医疗保健中的价值:来自日本的证据。

Value of new performance information in healthcare: evidence from Japan.

机构信息

Harvard Business School, 369 Morgan Hall, 15 Harvard Way, Boston, MA, 02163, USA.

Graduate School of Business Administration, Kobe University, 2-1 Rokkodai, Nada-ku, Kobe, 657-8501, Japan.

出版信息

Int J Health Econ Manag. 2020 Dec;20(4):319-357. doi: 10.1007/s10754-020-09283-1. Epub 2020 Aug 18.

Abstract

Mandatory measurement and disclosure of outcome measures are commonly used policy tools in healthcare. The effectiveness of such disclosures relies on the extent to which the new information produced by the mandatory system is internalized by the healthcare organization and influences its operations and decision-making processes. We use panel data from the Japanese National Hospital Organization to analyze performance improvements following regulation mandating standardized measurement and peer disclosure of patient satisfaction performance. Drawing on value of information theory, we document the absolute value and the benchmarking value of new information for future performance. Controlling for ceiling effects in the opportunities for improvement, we find that the new patient satisfaction measurement system introduced positive, significant, and persistent mean shifts in performance (absolute value of information) with larger improvements for poorly performing hospitals (benchmarking value of information). Our setting allows us to explore these effects in the absence of confounding factors such as incentive compensation or demand pressures. The largest positive effects occur in the initial period, and improvements diminish over time, especially for hospitals with poorer baseline performance. Our study provides empirical evidence that disclosure of patient satisfaction performance information has value to hospital decision makers.

摘要

强制性测量和结果指标披露是医疗保健中常用的政策工具。这种披露的有效性取决于强制性系统产生的新信息在多大程度上被医疗保健组织内化,并影响其运营和决策过程。我们使用来自日本全国医院组织的面板数据,分析了在规定要求标准化测量和同行披露患者满意度绩效之后的绩效改进情况。我们利用信息价值理论,记录了新信息对未来绩效的绝对价值和基准价值。在控制改进机会的上限效应的情况下,我们发现,新的患者满意度测量系统引入了积极、显著且持续的绩效均值转移(信息的绝对价值),表现较差的医院(信息的基准价值)的改进幅度更大。我们的研究环境使我们能够在没有激励补偿或需求压力等混杂因素的情况下探索这些影响。最大的积极影响发生在初始阶段,随着时间的推移,改进会逐渐减少,特别是对于基线绩效较差的医院。我们的研究提供了实证证据,表明患者满意度绩效信息的披露对医院决策者具有价值。

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