Weill Cornell Medicine, New York City, New York.
J Ambul Care Manage. 2021 Jan/Mar;44(1):21-30. doi: 10.1097/JAC.0000000000000367.
Value-based payment incentivizes primary care providers (PCPs) to refer patients to specialists inside their own organization. "Outmigration" of patients to specialists in other organizations is common, yet why it occurs is not clear. We conducted qualitative interviews of PCPs, nurses, and administrative staff at primary care practices in a physician organization (PO) to determine reasons for outmigration. While participants reported that they preferred making within-PO referrals, they identified 18 barriers to within-PO referrals, which often led to patients receiving care elsewhere. Many of these barriers are potentially modifiable and could inform the design of future interventions to decrease unnecessary outmigration.
基于价值的支付激励基层医疗服务提供者 (PCP) 将患者转介到自己组织内的专家。患者向其他组织的专家“外流”很常见，但发生的原因尚不清楚。我们对医师组织 (PO) 中的基层医疗实践中的 PCP、护士和行政人员进行了定性访谈，以确定“外流”的原因。虽然参与者报告说他们更喜欢进行 PO 内转介，但他们确定了 18 个 PO 内转介的障碍，这通常导致患者在其他地方接受治疗。这些障碍中的许多是潜在可改变的，可以为未来减少不必要的“外流”的干预措施的设计提供信息。
