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臨床費用と成果の高変性を特定し,コスト削減と品質の向上と関連付ける価値主導の成果プログラムの実施
Vivian S Lee1, Kensaku Kawamoto1, Rachel Hess1
1University of Utah, Salt Lake City.
JAMA
|September 14, 2016
まとめ
価値主導の成果ツールにより 医療費が削減され 特定の臨床プロジェクトで 患者の成果が改善されました 医者は実際の費用と結果を 理解することで 個々の患者のケアを向上させることができます
科学分野:
- 医療サービス研究
- 健康 経済
- 臨床品質の向上
背景:
- アメリカの医療制度は 量に基づいた医療から 価値に基づいた医療へと移行しています
- 個々の患者レベルでのコストと成果の正確な測定は この変革にとって極めて重要です
研究 の 目的:
- 価値主導の成果ツールがコスト削減と健康成果の最適化に与える影響を評価する.
- 医療費と品質の測定は 患者の個別の経験に割り当てられます
主な方法:
- 2012年から2016年までユタ州立大学で無制御の長期観察研究が行われました.
- 医師は,プロセス改善の専門家と協力して,結果,コスト,および変化に関するデータを提供するツールを活用しました.
- 主な指標は,直接コスト,コスト変動率,複合品質指数でした.
主要な成果:
- 総関節交換の品質指数は54%から80%に改善され,実施後の平均直接コストは11%減少しました.
- 病院の検査費用は1日15ドル減った.
- セプシスでは,抗感染薬の投与までの平均時間は4. 1時間減少した.
結論:
- 大規模な医療システムで 価値主導の成果ツールを実装することで 選択された臨床領域でコストが削減され 品質が向上しました
- 医師に実際の患者レベルでの費用と結果データを提供することは,臨床的意思決定とケア提供に役立ちます.
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