Evaluation of care coordination program on cost containment: cambridge health alliance case in the united states

Kadir GÜRSOY (Sosyal Güvenlik Kurumu, Sosyal Güvenlik Uzmanı, Türkiye)
SOSYAL GÜVENLİK DERGİSİ
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Yıl: 2015 Cilt: 5 Sayı: 1 Sayfa Aralığı: 165 - 189 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

Evaluation of care coordination program on cost containment: cambridge health alliance case in the united states

Öz:
Amerikada artan sağlık giderleri, sağlık sektöründeki paydaşlar için büyük bir sorun oluşturmaktadır. Bu yüzden her paydaş, maliyetleri kısma adına yeni stratejiler geliştirmektedirler. Kişiye özel sağlık hizmetlerinin koordinasyonu, bu sorunu çözme adına sağlık hizmeti sunucuları tarafından geliştirilen yöntemlerden bir tanesidir. Cambridge Health Alliancebüyük Boston sınırları içinde hizmet veren kamu güvenlik ağı sağlık sistemi sunucusuKasım 2011den bu yana örnek bir grup için koordinasyon programının pilot uygulamasını yapmaktadır. Bu makale, bu programın sağlık maliyetleri üzerine etkisini ölçmekte, örmek grup içindeki farklı alt grupların hangisinin maliyetleri daha çok aşağıya çektiğini anlamak için maliyet yapısını analiz etmekte ve en büyük tasarrufu sağlamak için önerilerde bulunmaktadır. Analizler, programın maliyet dağılımını değiştirmede başarılı olduğu ve programın en maliyetli hastaları kapsaması durumunda maliyet artış hızında azalma sağladığı sonuçlarına ulaşmaktadır. Ama, analizlerin daha büyük bir örneklemi ve daha uzun süreli kontrol dönemini içerecek şekilde geliştirilmeye ihtiyacı vardır. Son olarak, programın; koruyucu sağlık, uzun dönemde maliyetleri sürdürülebilir hale getirecek yeni ödeme sistemleri, aile hekimi sistemi gibi başka politikalarla desteklenmesi önem arz etmektedir.
Anahtar Kelime:

Konular: İşletme İktisat

Kişiye özel sağlık hizmetlerinde koordinasyon programının maliyet kontrolü bağlamında değerlendirilmesi: amerika birleşik devletleri ndeki cambridge health alliance örneği

Öz:
Rising healthcare costs in nearly all nations, particularly in the United States, has been posing major challenges to stakeholders in healthcare industry. Each actor has been developing new strategies to mitigate costs. Care coordination is one of the methods many healthcare providers have been applying to remedy this problem. Cambridge Health Alliance - a public, safety net health care system serving the Greater Boston area- has been piloting a care coordination program for one of its population cohorts since November 2011. This paper evaluates the possible impact of the program on healthcare costs, analyzes cost structure for different subpopulations to understand which groups contribute most to cost reductions, and offer suggestions to achieve the highest saving. The analyses conclude there is room for curbing the cost growth when the program targets the highest cost patient and the program succeeds in changing the cost concentration of healthcare spending. Nevertheless, the analyses need to be developed further, using bigger population and a longer intervention period. Finally, it is important to support the program with other policies such as a gate keeping system, preventive care, and new alternative payment systems to sustain an impact on costs in the long-run.
Anahtar Kelime:

Konular: İşletme İktisat
Belge Türü: Makale Makale Türü: Derleme Erişim Türü: Erişime Açık
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APA GÜRSOY K (2015). Evaluation of care coordination program on cost containment: cambridge health alliance case in the united states. , 165 - 189.
Chicago GÜRSOY Kadir Evaluation of care coordination program on cost containment: cambridge health alliance case in the united states. (2015): 165 - 189.
MLA GÜRSOY Kadir Evaluation of care coordination program on cost containment: cambridge health alliance case in the united states. , 2015, ss.165 - 189.
AMA GÜRSOY K Evaluation of care coordination program on cost containment: cambridge health alliance case in the united states. . 2015; 165 - 189.
Vancouver GÜRSOY K Evaluation of care coordination program on cost containment: cambridge health alliance case in the united states. . 2015; 165 - 189.
IEEE GÜRSOY K "Evaluation of care coordination program on cost containment: cambridge health alliance case in the united states." , ss.165 - 189, 2015.
ISNAD GÜRSOY, Kadir. "Evaluation of care coordination program on cost containment: cambridge health alliance case in the united states". (2015), 165-189.
APA GÜRSOY K (2015). Evaluation of care coordination program on cost containment: cambridge health alliance case in the united states. SOSYAL GÜVENLİK DERGİSİ, 5(1), 165 - 189.
Chicago GÜRSOY Kadir Evaluation of care coordination program on cost containment: cambridge health alliance case in the united states. SOSYAL GÜVENLİK DERGİSİ 5, no.1 (2015): 165 - 189.
MLA GÜRSOY Kadir Evaluation of care coordination program on cost containment: cambridge health alliance case in the united states. SOSYAL GÜVENLİK DERGİSİ, vol.5, no.1, 2015, ss.165 - 189.
AMA GÜRSOY K Evaluation of care coordination program on cost containment: cambridge health alliance case in the united states. SOSYAL GÜVENLİK DERGİSİ. 2015; 5(1): 165 - 189.
Vancouver GÜRSOY K Evaluation of care coordination program on cost containment: cambridge health alliance case in the united states. SOSYAL GÜVENLİK DERGİSİ. 2015; 5(1): 165 - 189.
IEEE GÜRSOY K "Evaluation of care coordination program on cost containment: cambridge health alliance case in the united states." SOSYAL GÜVENLİK DERGİSİ, 5, ss.165 - 189, 2015.
ISNAD GÜRSOY, Kadir. "Evaluation of care coordination program on cost containment: cambridge health alliance case in the united states". SOSYAL GÜVENLİK DERGİSİ 5/1 (2015), 165-189.
Sayfa Oluşturulma Tarihi
22-04-2024 21:1

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