解决医疗不足和过度使用的杆:实现高价值的医疗保健
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
概括
解决医疗服务的不足和过度使用需要了解系统层面的因素并实施上游解决方案. 赋予患者权力和定制政策是实现对所有人的正确护理的关键.
科学领域:
- 医疗服务研究
- 医疗保健政策
- 公共卫生
背景情况:
- 医疗保健服务的不足和过度使用是普遍存在的问题,
- 这些问题源于医疗保健系统的复杂多元因素.
- 实现正确的护理需要解决系统驱动因素和临床接触激励因素.
研究的目的:
- 研究一系列消除医疗不足和过度使用的策略.
- 探索影响医疗保健服务利用的系统级因素.
- 确定促进公平有效的医疗服务的变革杆.
主要方法:
- 分析系统层面的因素,包括资源分配和优先设定工具,如医疗技术评估.
- 检查影响临床接触的激励因素.
- 审查潜在的政策干预措施,区分普遍适用和特定环境的方法.
主要成果:
- 系统层面的因素,如资源分配和医疗技术评估是医疗保健利用的关键驱动因素.
- 有效的干预措施包括增加患者的积极性,并根据当地环境定制政策.
- 增加政策变化是不够的; 需要转型性方法.
结论:
- 消除医疗不足和过度使用需要一个全面的上游方法,重点关注系统层面的因素.
- 患者赋权,公众意识和动员等普遍策略具有显著的前景.
- 政策干预必须超越渐进式调整,从根本上促进正确的护理.
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