大图 VBHC:一个雨审查
Ana Moreira1,2, José Crispim3,4
1Unidade Local de Saúde São João, Porto, Portugal. moreira.asofia@gmail.com.
BMC health services research
|December 2, 2025
概括
基于价值的医疗保健 (VBHC) 可以提高患者的治疗成果和降低成本,但采用它面临着挑战. 主要优先事项包括标准化指标,调整支付,提高透明度,以成功实现卫生系统转型.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 医疗保健管理的管理
- 卫生经济学 卫生经济学
背景情况:
- 基于价值的医疗保健 (VBHC) 旨在改善患者的结果并优化成本.
- 全球采用VBHC是不一致的,由于上下文因素和利益相关者的动态.
- 障碍包括组织惯性,数据问题和有限的患者报告结果数据.
研究的目的:
- 综合全球关于VBHC实施的证据.
- 识别VBHC中的关键影响,挑战和机会.
- 评估VBHC的有效性,并为未来的研究和系统改进提供信息.
主要方法:
- 对VBHC (2006-2024) 的综合评论和元分析的综合综述.
- 在四个数据库中进行系统搜索.
- 以上下文,干预,机制,结果 (CIMO) 框架为指导的数据提取;使用Joanna Briggs Institute检查清单进行质量评估.
主要成果:
- 在降低成本的同时,VBHC倡议显示出提高质量,效率和患者满意度的潜力.
- 持续面临的挑战包括碎片化指标,患者报告结果指标 (PROM) 和患者报告体验指标 (PREM) 的有限整合,以及对变化的抵抗.
- 支付模式带来混合的结果; 基于价值的保险设计提高了保险的坚持; 减少低价值的护理显示中等成功; 技能差距阻碍了采用.
结论:
- 为了实现卫生系统转型,VBHC需要在结构,文化,技术和教育方面进行协调改革.
- 优先事项包括标准化结果指标,调整支付与价值,提高成本透明度和利益相关方参与.
- 未来的研究应该解决上下文障碍,完善评估方法,并增加患者参与度.
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