重新构建以价值为基础的护理管理:超越成本降低,以患者为中心
Priscilla Wang1,2, Maryann Vienneau1, Christine Vogeli3
1Population Health Management, Mass General Brigham, Boston, Massachusetts.
JAMA health forum
|June 16, 2023
概括
护理管理计划旨在改善患者的治疗结果,并降低基于价值的护理中的成本. 然而,分散和缺乏协调的风险是计划失败,需要以患者为中心的有效性和公平性框架.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 基于价值的医疗保健
背景情况:
- 护理管理计划是以价值为基础的护理的基础,承诺更好的患者结果和降低医疗保健成本.
- 这些计划的扩散和专业化可能会导致分散,低效和无法满足患者需求的风险.
研究的目的:
- 审查目前的护理管理状况,并确定关键挑战.
- 提出一个重定向护理管理的框架,使护理管理更加以患者为中心和有效.
- 为实施提供指导和政策建议.
主要方法:
- 文献综述和当前护理管理实践的综合.
- 分析挑战,包括不清楚的价值主张,系统与患者为中心的结果,碎片化和缺乏协调.
- 关于以患者为中心的护理管理的拟议框架的制定.
主要成果:
- 确定了关键挑战:价值主张不明确,系统重点超过患者重点,由于专业化的碎片化和协调不良.
- 拟议的框架强调了动态的患者需求,编程的连续性,实体间协调和以患者为中心的结果评估.
- 关于卫生系统实施的指导和政策建议,以激励高价值,公平的计划.
结论:
- 将护理管理重定向到以患者为中心的框架对于有效性和公平性至关重要.
- 政策制定者和卫生领导人可以提高护理管理价值,减少患者负担.
- 利益相关者之间加强协调对于成功的护理管理计划至关重要.
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