医疗保健服务中电子咨询的评估

A. Prakash, Qiaochu He, Xiang Zhong
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引用次数: 1

摘要

电子咨询提供了一个数字平台,初级保健提供者(PCP)可以咨询专家并获得反馈,或者向患者提供直接的专业转诊。在这项工作中,我们的目标是调查电子咨询是否可以帮助患者匹配正确的护理提供者(PCP或专科医生)并减少延误。我们使用分析框架提供了电子咨询操作的高级抽象,该框架量化了电子咨询在灵活服务系统中有效匹配的背景下的好处。对于缺乏病情严重程度信息的异质性患者,我们开发了一个贝叶斯框架来估计真实的严重程度,以电子咨询效能水平作为参数,衡量pcp和专家沟通和信息共享的程度。患者对电子咨询的反应是基于他们的感知效用,这对延迟和错配成本很敏感。在激励相容假设下,确定了完美电子会诊和不完美电子会诊的均衡患者流。研究了柔性服务系统的基本特性和电子咨询员的价值。我们分析得出结论,电子咨询,当越来越完善地实施时,提高了护理服务系统的运营和经济绩效。如果设计得当,电子咨询有望通过简化患者流程、提高护理质量、降低成本和减少冗余来改善患者获得护理的机会。
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Evaluation of E-Consults in Healthcare Delivery
E-onsults offer a digital platform where primary care providers (PCP) can consult the specialists and obtain feedback or offer a direct specialty referral to the patients. In this work, we aim to investigate whether e-consults can help match patients to the right care provider (PCP or Specialist) and reduce delays. We offer a high-level abstraction of e-consult operations using an analytical framework that quantifies the benefit of e-consults in the context of efficient matching in a flexible service system. With heterogeneous patients who lack information regarding the severity of their condition, a Bayesian framework is developed to estimate the true severity, parametrized by the level of e-consult efficacy, a measure of the degree of PCPs and specialists’ communication and information sharing efforts. Patients react to e-consults based on their perceived utility which is sensitive to delay and mismatch costs. Under incentive compatibility assumptions, equilibrium patient flows given perfect and imperfect e-consults are identified. Fundamental properties of the flexible service system and the value of e-consults are investigated. We conclude analytically that, e-consults, when implemented with increasing perfection, enhance the operational and economic performance of the care delivery system. When designed appropriately, e-consults offer the promise to improve patient access to care with streamlined patient flow, improved care quality, and reduced costs and redundancies.
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