成本,价值和变化
Matthew A Pappas1, Hannah K Bassett2, Amit Pahwa3
1Cleveland Clinic, Center for Value-based Care Research, Cleveland, OH, USA; Department of Hospital Medicine, Cleveland Clinic, Cleveland, OH, USA; Cleveland Clinic Lerner College of Medicine of Case Western University, Cleveland, OH, USA.
The Medical clinics of North America
|August 2, 2025
概括
由于数据不准确和医疗服务影响不大,估计医疗保健成本和收益具有挑战性. 了解医疗实践的变化是质量改善举措的关键.
科学领域:
- 卫生经济学 卫生经济学
- 医学实践分析 医学实践分析
背景情况:
- 医疗保健成本估计面临着固定和间接成本的挑战.
- 量化医疗服务的好处,包括降低死亡率和改善生活质量,本质上是不准确的.
- 由于科学不确定性,从业者技能和复杂的系统,医疗实践表现出固有的变化.
研究的目的:
- 探索医疗保健成本和收益估计中固有的不精确性.
- 确定医疗实践中变化的来源.
- 突出了解变化的实用性,以提高质量.
主要方法:
- 对成本归因挑战 (直接与间接/固定成本) 的定性分析.
- 评估福利估计困难 (死亡率,生活质量).
- 探索导致医疗实践变化的因素.
主要成果:
- 直接的变量成本比固定和间接成本更容易追踪.
- 大多数医疗服务对死亡率的影响很小,改善生活质量很难量化.
- 医疗实践的变化源于证据的不确定性,从业者的局限性和系统因素.
结论:
- 很难准确估计医疗保健服务的收益和成本.
- 了解医疗实践变化的来源对于指导质量改进工作至关重要.
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