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直接初级医疗:财务分析及其重塑美国医疗格局的潜力。

Direct Primary Care: Financial Analysis and Potential to Reshape the U.S. Healthcare Landscape.

作者信息

Tecco Halle, Rahim Faraan Owais, Lalwani Pooja, Palakodeti Sandeep

机构信息

Columbia Business School, New York, NY, USA.

Harvard Medical School, Boston, MA, USA.

出版信息

J Gen Intern Med. 2025 Feb;40(2):448-452. doi: 10.1007/s11606-024-09038-5. Epub 2024 Sep 25.

Abstract

As the United States faces a looming shortage of primary care physicians and escalating rates of clinician burnout, there is a pressing need to explore alternative models of primary care delivery. Direct Primary Care (DPC) is an emerging primary care model in which patients enroll in a membership plan and make direct monthly or yearly payments to a DPC practice for specific primary care services. Although DPC holds the potential to enhance patient care and mitigate clinician burnout, no published studies provide a financial analysis of DPC practices or compare them to traditional fee-for-service (FFS) primary care models. In this article, we present an evidence-based analysis of theoretical DPC and FFS primary care practices. We demonstrate that the DPC practice can yield upwards of $25,000 in annual cost savings over the FFS practice while also providing more personalized patient care. Thus, we argue that the cost-effectiveness and value-based approach of DPC positions the model as a transformative force in reshaping the American healthcare landscape towards a more patient-centric, accessible, and resilient future.

摘要

随着美国面临基层医疗医生迫在眉睫的短缺以及临床医生职业倦怠率不断上升,迫切需要探索替代的基层医疗服务模式。直接初级保健(DPC)是一种新兴的基层医疗模式,患者加入会员计划,并每月或每年直接向DPC诊所支付特定基层医疗服务的费用。尽管DPC有潜力改善患者护理并减轻临床医生的职业倦怠,但尚无已发表的研究对DPC诊所进行财务分析,或将其与传统的按服务收费(FFS)基层医疗模式进行比较。在本文中,我们对理论上的DPC和FFS基层医疗实践进行了基于证据的分析。我们证明,与FFS实践相比,DPC实践每年可节省超过25,000美元的成本,同时还能提供更个性化的患者护理。因此,我们认为DPC的成本效益和基于价值的方法使该模式成为重塑美国医疗格局、迈向更以患者为中心、更易获得和更具韧性未来的变革力量。

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