在外科手术中重新定义"价值":为门诊内分泌手术开发综合价值评分
Noel F Ayoub1,2, Julia Noel1, Lisa A Orloff1
1Department of Otolaryngology-Head and Neck Surgery, Division of Head and Neck Surgery, Stanford University School of Medicine, Stanford, California, USA.
概括
医疗保健的新价值方程式通过包括23个质量和成本输入来改进标准模型. 这种详细的方法提供了特定疾病的价值得分,并证明了远程医疗服务的潜在价值增加.
科学领域:
- 医疗保健管理的管理
- 卫生经济学 卫生经济学
- 外科手术的结果
背景情况:
- 基于价值的标准医疗保健模式 (价值=质量/成本) 在临床相关性方面是有限的.
- 需要一种更全面的方法来准确评估医疗保健价值.
研究的目的:
- 为医疗保健引入一种全新的,详细的价值方程.
- 为了将现实世界的临床和成本数据纳入疾病特异性价值得分.
- 为了证明方程在手术环境中的实用性.
主要方法:
- 开发了一个新的医疗保健价值方程,有23个输入 (16个质量,7个成本).
- 在高等教育机构进行了前性观察研究.
- 招募了接受甲状腺或副甲状腺手术的患者,生成手术特定的值得分.
- 在远程医疗访问中进行了次分析.
主要成果:
- 招募了10名患者 (60%为女性,平均年龄为62岁).
- 每名患者的平均总成本为41,884美元.
- 开发的方程平均质量得分为0.99,成本得分为6.1,结果是价值得分为0.19.
- 使用远程医疗为术后访问增加了0.66%的价值得分.
结论:
- 新方程式提供了对外科手术服务价值的全面评估.
- 它整合了客观/主观结果和健康公平,用于定量比较.
- 这个框架可以指导未来基于价值的医疗保健评估和改进.
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