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Principles of Rodent Surgery for the New Surgeon
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了解手术使用的区域差异
John D Birkmeyer1, Bradley N Reames, Peter McCulloch
1Center for Healthcare Outcomes and Policy, University of Michigan, Ann Arbor, MI 48109, USA. jbirkmey@umich.edu
Lancet (London, England)
|October 1, 2013
概括
常见的外科手术率的区域差异主要是由医生的信念和患者偏好的整合驱动的,而不仅仅是疾病负担或诊断实践. 解决这些因素是减少外科手术差异的关键.
科学领域:
- 医疗服务研究 医疗服务研究
- 外科手术的结果
- 临床决策 临床决策
背景情况:
- 在使用常见的外科手术程序方面存在显著的区域差异.
- 疾病负担,诊断实践和患者态度仅解释了这些差异的一小部分.
研究的目的:
- 调查手术手术率区域差异的主要驱动因素.
- 了解医生信仰和患者偏好在手术决策中的作用.
主要方法:
- 分析导致手术率差异的因素.
- 检查影响手术变化的临床决策组件.
主要成果:
- 医生对手术指示的信念是区域差异的主要决定因素.
- 患者偏好融入决策的程度显著影响了手术率.
- 技术,专业供应和金融激励等环境因素也发挥着作用.
结论:
- 减少手术变异需要解决医生的决策和患者偏好的整合.
- 传播比较有效性证据和共享决策辅助工具对于偏好敏感的条件至关重要.
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