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病院主義運動は5年後に始まった
Robert M Wachter1, Lee Goldman
1Department of Medicine, University of California, San Francisco, Box 0120, San Francisco, CA 94143-0120, USA. bobw@medicine.ucsf.edu
JAMA
|February 2, 2002
まとめ
ホスピタリストモデルは,医療の質や患者の満足度に悪影響を及ぼさず,病院の効率を向上させ,費用と滞在期間を削減します. この成長するモデルは,医学教育に潜在的利益をもたらすことも示しています.
科学分野:
- ヘルスケア・マネジメント・ヘルスケア・マネジメント
- 入院医療モデル 患者の介護モデル
- 医療専門分野 医療専門分野
背景:
- 1996年に初めて説明された入院医療の病院モデルでは,実質的な成長が見られました.
- この拡大は,医療システムに重大な臨床的,財務的,教育的,政策的影響を及ぼします.
研究 の 目的:
- 医療従事者の資源利用,医療の質,患者満足度,医療教育への影響に関する既存のデータをレビューする.
- 医療システムに対する病院医のより広範な影響を分析し,主要な課題と将来の方向性を特定する.
主な方法:
- 1996年から2001年9月までの間,主要なデータベース (MEDLINE,BIOSIS,EMBASE,コクラン図書館) で広範な文献検索が行われました.
- 病院介護と対照群を比較した研究は,資源使用,品質,患者の満足度に関連する結果に基づいて選択されました.
主要な成果:
- ホスピタリストプログラムの実施は,病院費の大幅な削減 (平均13.4%の減少) と入院の平均期間 (平均16.6%の減少) と関連していました.
- いくつかの研究では,死亡率の減少などの改善された臨床結果を示しましたが,これらの結果は矛盾していました.
- 患者の満足度は一般的に維持され,いくつかの証拠は,医学教育の肯定的な効果を示唆しています.
結論:
- 経験的証拠は,医療従事者が医療の質や患者の満足度を損なうことなく,入院患者の効率性を向上させることを支持しています.
- 病院医の分野は急速に拡大しており,病院医はますます教育,研究,質の向上の役割を担っています.
- ホスピタリストモデルは,従来の医療専門分野の特徴を示し,継続的な成長と医療システムへの統合の準備を整えています.
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