通讯作者: 张叶, 404616523@qq.com

DOI：10.12201/bmr.202206.00011

The experience of American peritoneal dialysis favored policy and its enlightenment to China

• 摘要：目的：梳理美国腹膜透析激励政策 (peritoneal dialysis favored policy,PD-Favored) 的实施背景和发展历程,为我国居家腹膜透析治疗模式的推广提供经验借鉴。方法：基于文献分析法,系统总结美国实施PD-Favored政策的主要措施和效果。结果：美国PD-Favored政策主要通过以下四类措施影响供需双方行为：建立前瞻性捆绑支付模式以引导医疗机构提供腹膜透析；通过按人头付费提高医生提供腹膜透析的积极性；通过设立等待期、限制频繁透析和实施治疗选择教育计划引导患者采用腹膜透析；实施质量激励计划以及推动腹膜透析治疗技术创新。 结论：美国PD-Favored政策通过医保支付、政府调控等手段影响供需双方的行为,有效促进腹膜透析的普及。未来我国在推广居家腹膜透析模式的过程中应重在完善医保支付政策,采用多学科方法对患者进行透析前教育,确定中国化腹膜透析质量管理目标以及促进自动腹膜透析等技术的发展。

  关键词： 终末期肾病; 腹膜透析激励政策; 居家腹膜透析

   

  Abstract: Objective：The purpose of this study is to study the policies of peritoneal dialysis favored policy (PD-Favored) in the United States, sort out its background and development process, then provide experience for China to promote home peritoneal dialysis. Methods: Based on scoping review, we systematically summarized the measures and effects of PD-Favored policy in the United States. Results: PD-Favored policy in the United States mainly influence the behaviors of supply and demand through the following four measures: establish the End Stage Renal Disease Prospective Payment System; Increase physicians motivation to provide peritoneal dialysis by establishing the monthly capitated payment; guide patient to adopt peritoneal dialysis by establishing waiting periods, limiting frequent dialysis, and implementing treatment options education program; implement quality incentive programs and promote technological innovation in peritoneal dialysis treatments. Conclusions: PD-Favored policy in the United States have influenced the behaviors of supply and demand by means of medical insurance payment and government regulation. It has effectively promoted the popularity of peritoneal dialysis. In the future, to promote home peritoneal dialysis, China should improve its medical insurance payment policy, adopt a multidisciplinary approach to pre-dialysis education for patients, set up the quality management target of Chinese peritoneal dialysis and promote the development of automatic peritoneal dialysis.

  Key words: End stage renal disease ；peritoneal dialysis favored policy；home peritoneal dialysis; ; 

  提交时间：2022-06-15

  版权声明：作者本人独立拥有该论文的版权，预印本系统仅拥有论文的永久保存权利。任何人未经允许不得重复使用。
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• 序号	提交日期	编号	操作
  1	2022-02-20	bmr.202206.00011V1	下载

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