医生如何改变医疗保健的未来
Michael E Porter1, Elizabeth Olmsted Teisberg
1Harvard University, Cambridge, Mass, USA. mporter@hbs.edu
JAMA
|March 16, 2007
概括
医生主导的改革侧重于患者价值和可衡量的结果对于医疗保健至关重要. 这种方法促进了争取更好的结果的竞争,使患者和医生受益,同时控制成本.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 医学经济学 医学经济学
- 医疗保健管理的管理
背景情况:
- 目前的医疗改革工作往往优先考虑降低成本,而不是患者的福祉,对医生和患者产生负面影响.
- 医生领导对于推动医疗保健价值的有意义改善至关重要.
研究的目的:
- 提出以市场为基础,由医生领导的医疗改革战略,以提高患者价值为中心.
- 概述围绕疾病和护理周期组织医疗实践的原则,以改善结果.
主要方法:
- 倡导转向以价值为基础的竞争,供应商在可衡量的结果上竞争.
- 强调风险调整结果和成本测量的重要性,以推动改进.
- 强调医生领导力在实施这些改革的必要性.
主要成果:
- 基于价值的竞争可以带来更好的患者护理,医生奖励卓越,并控制成本.
- 围绕疾病和护理周期组织医疗实践可以提高效率和有效性.
- 医生主导的改革增加了专业满意度,并减少了行政负担.
结论:
- 医疗改革必须优先考虑患者价值,由医生领导和结果竞争驱动.
- 实施以价值为基础的系统需要围绕条件和测量结果组织护理.
- 医生未能领导这种变化,就有可能增加对医学的行政控制.
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