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生命维持疗法.维持生命的治疗. 一个适合使用的模型
1Department of Health Care Sciences, George Washington University Medical Center, Washington, DC 20037.
需要新的策略来管理维持生命的疗法,这些疗法对患者的益处很小. 一个拟议的模型基于有效性,实用性和成本来定义不适当的护理,旨在更好地分配资源.
科学领域:
- 医学伦理 医学伦理
- 卫生经济学 卫生经济学
- 老年医学 老年医学
背景情况:
- 人们越来越多地使用维持生命的疗法,即使这种疗法很少有益.
- 越来越需要框架来指导医疗干预的适当使用.
研究的目的:
- 为确定适当使用维持生命疗法的新型模型提出建议.
- 定义评估治疗适当性的医疗和经济标准.
主要方法:
- 开发一个包含治疗有效性,患者效用和边际成本的模型.
- 该模型的应用,以分析慢性疾病的老年人医院外心肺复苏.
主要成果:
- 被认为在医学上不合适 (很少有效/理想) 或在经济上不合适 (边际成本效益比较高) 的疗法不应自动提供.
- 该模型提供了医学徒劳的操作定义.
结论:
- 拟议的模型提供了一个结构化的方法来制不适当的维持生命的护理.
- 预先指示和生存预测等现有策略单独是不够的.
- 该框架支持在医疗保健资源分配方面基于证据的决策.
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