まとめ
検査用に対する医師のフィードバックにより,血液検査とX線検査の注文が14.2%減少した. このコストフィードバックの介入は,リターンフィードバックまたは教育のみとは異なり,インターニストの間で診断テストの利用率を効果的に低下させた.
科学分野:
- 医療サービス 研究 医療サービス
- クリニカル・プラクティスの改善
- 医学経済学 医学経済学
背景:
- 診断検査の過剰利用は,医療費に寄与しています.
- 医者が一般的な血液検査やレントゲノグラムのパターンを注文する際には,変動性があります.
- 医療環境におけるテスト利用を最適化するために,効果的な介入が必要である.
研究 の 目的:
- インターニストの間で一般的な診断検査の使用率に3つの介入の影響を評価する.
- テスト利用率を減らすためのコストフィードバック,リターンフィードバック,教育プログラムの有効性を比較する.
- 医師の間で検査注文の変動性に対するこれらの介入の影響を評価する.
主な方法:
- 健康維持組織のインターニストを対象としたクロスオーバー設計研究.
- 介入には,個々の試験使用率の秘密のピア比較 (コストフィードバック) が含まれていた.
- 他の介入は,異常なテスト結果率に関するフィードバック (リターンフィードバック) とテスト特有の教育でした.
主要な成果:
- 費用フィードバック期間中に12の一般的な血液検査とレントゲノグラムの総使用量は14.2%減少しました.
- 12件の試験のうち11件で,コストフィードバックによる使用量の減少が示されました.
- 利回りフィードバックと教育介入は,テストの利用または変動性に一貫した効果を示さなかった.
結論:
- 利用率の信頼性の高いピア比較 (コストフィードバック) は,内科医の診断検査の使用を減らすための効果的な戦略です.
- 利回りフィードバックと教育的介入は,医師のテスト注文行動を修正する上で効果的ではなかった.
- コストフィードバックはまた,医師の間でテスト注文の変動性の有意な減少を示した.
関連する概念動画
01:26Methods Of Healthcare Delivery System
At the different levels of the healthcare system, we see varying methods of healthcare used. These methods include managed care systems, case management, and primary healthcare.
Managed Care System:
The managed care system is designed to control the cost while maintaining the quality of care. The patient's care from admission to discharge is planned by the primary care provider or the case manager, also known as the gatekeeper. In a managed care system, the number of care providers is limited...
Managed Care System:
The managed care system is designed to control the cost while maintaining the quality of care. The patient's care from admission to discharge is planned by the primary care provider or the case manager, also known as the gatekeeper. In a managed care system, the number of care providers is limited...
01:26Traditional Level Of Health Care System
The levels of care describe the services provided in the healthcare system. Accordingly, there are six levels of the traditional healthcare system in the US: preventive, primary, secondary, tertiary, restorative, and continuing healthcare. A nurse must understand how the healthcare industry organizes and provides services within these levels of care.
The preventive healthcare service includes tests for screening. Preventive health care services include identifying and reducing disease risk...
The preventive healthcare service includes tests for screening. Preventive health care services include identifying and reducing disease risk...
01:30Preventive Healthcare Services
Preventive healthcare services keep people healthy via frequent check-ups, screening, and counseling. They primarily aid in disease prevention rather than treating an acute or chronic illness. Preventive treatment also keeps individuals productive and energetic, allowing them to work well into their retirement years. Examples of preventive care services include:
01:11Purpose of Health Records I
The vital purpose of health records is to provide a complete and accurate account of a patient's medical history, including communication, diagnostic and therapeutic orders, care planning, research, and quality review.
Here's a breakdown of how health records serve these purposes:
Here's a breakdown of how health records serve these purposes:
01:29Documentation in Long-Term and Home Healthcare Setting
Documentation in long-term care facilities and home healthcare settings is crucial for ensuring continuous, coordinated, and comprehensive care for patients. Each setting has its specific documentation processes and tools:
Long-Term Care Facilities
Long-Term Care Facilities
01:30Health Information Technology and Healthcare Information System
Health Information Technology (HIT)
Health Information Technology, commonly called HIT, integrates advanced information systems and technology in healthcare settings. Its primary functions include:
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