减少低价值的医疗保健实践,支持可持续的脏护理
Scott McAlister1, Valerie A Luyckx2, Andrea K Viecelli3
1Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia; Centre for Health Policy, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia.
Kidney international
|March 21, 2024
概括
减少低价值护理对于医疗保健脱碳至关重要. 这涉及考虑临床,成本和社区观点,以确保在医疗保健排放方面进行道德和公平的减少.
科学领域:
- 环境科学 环境科学
- 卫生政策 卫生政策
- 医学伦理 医学伦理
背景情况:
- 医疗保健对全球碳排放作出了重大贡献 (5.5%).
- 脱碳努力往往忽视了需求侧管理和低价值护理.
- 大约20%的全球医疗保健支出被认为是低价值的.
研究的目的:
- 从多个角度研究医疗保健中的价值概念.
- 探索减少低价值护理如何有助于医疗保健脱碳.
- 以道德和公平的方式确定消除低价值护理的战略.
主要方法:
- 审查医疗保健中的三个主要价值观点:临床有效性,成本效益和社区观点.
- 分析这些观点如何定义低价值护理.
- 考虑非实施时的伦理和公平性影响.
主要成果:
- 低价值护理在临床 (益处与危害),成本效益 (愿意为QALYs支付费用) 和社区 (以患者为中心,共享决策) 视角上有所不同.
- 减少低价值护理是医疗保健脱碳的一个关键策略.
- 取消实施必须平衡减排与患者自主权,社会价值观和公平.
结论:
- 医疗保健的脱碳化需要专注于通过需求侧管理来减少低价值护理.
- 一个多角度的方法 (临床,成本,社区) 对于定义和减少低价值护理至关重要.
- 需要道德和公平的撤销实施策略,包括教育和透明度.
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