医療の過度な利用と不足に対処するためのレバー:高価値の医療の実現
Adam G Elshaug1, Meredith B Rosenthal2, John N Lavis3
1Menzies Centre for Health Policy, School of Public Health, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia; Lown Institute, Brookline, MA, USA.
Lancet (London, England)
|January 13, 2017
まとめ
医療サービスの過度な利用や不足に対処するには,システムレベルの要因を理解し,上流ソリューションを実装する必要があります. 患者の能力向上と政策の調整は,すべての人に適切なケアを実現するための鍵です.
科学分野:
- 医療サービス研究
- 医療政策
- 公衆衛生
背景:
- 医療サービスの不足と過剰利用は,世界的な健康への重大な影響を及ぼす広範な問題です.
- これらの問題は 医療制度内の複雑で多元的な要因に起因しています
- 適切なケアを実現するには システム的な要因と臨床的接触のインセンティブの両方に対処する必要があります
研究 の 目的:
- 医療の不足と過剰の使用を排除するための様々な戦略を調査する.
- 医療サービスの利用に影響を与えるシステムレベルの要因を探求する.
- 公平で効果的な医療提供を促進する 変化のレバーを特定する
主な方法:
- 医療技術評価などの資源配分と優先順位設定ツールを含むシステムレベルの要因の分析
- 臨床体験に影響を与えるインセンティブの検討
- 潜在的政策介入の見直し,普遍的に適用可能なアプローチと,状況特有のアプローチを区別する.
主要な成果:
- 資源配分や医療技術評価などのシステムレベルの要因は,医療利用の重要な要因です.
- 効果的な介入には 患者の活動を増やし 政策を現地状況に合わせるなどがあります
- 政策の段階的な変化は不十分で 変革的なアプローチが必要である
結論:
- 医療の不足と過剰の使用を排除するには,システムレベルの要因に焦点を当てた包括的な上流アプローチが必要です.
- 患者エンパワーメントや 市民の意識や 動員といった 普遍的な戦略は 大きく有望なものです
- 政策の介入は段階的な調整を超えて 根本的に適切なケアを促進するように設計されなければならない.
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