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Defining and Implementing Value-Based Health Care: A Strategic Framework

机译:定义和实施基于价值的医疗保健:战略框架

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摘要

Value in health care is the measured improvement in a person’s health outcomes for the cost of achieving that improvement. While some descriptions conflate value-based health care and cost reduction, quality improvement, or patient satisfaction, those efforts—while important—are not the same as value, which focuses primarily on improving patient health outcomes. A decade of research into organizations that have achieved better outcomes while often lowering costs suggests a strategic framework for value-based health care implementation that starts with identifying and understanding a segment of patients whose health and related circumstances create a consistent set of needs. An interdisciplinary team of caregivers then comes together to design and deliver comprehensive solutions to address those needs. The team measures the health outcomes and costs of its care for each patient and uses that information to drive ongoing improvements. Care provided in this way aligns delivery with how patients experience their health and reconnects clinicians to their purpose as healers. It also asks physicians to think differently about their role within the larger care team and about the services that team provides. The authors suggest medical schools should incorporate education on the principles and implementation of value-based health care throughout the undergraduate medical curriculum to prepare their graduates to lead the transformation to value-based health care as they enter the physician workforce.
机译:卫生保健的价值是指衡量一个人的健康状况所取得的改善的价值,以实现改善的成本为依据。尽管有些描述将基于价值的医疗保健和成本降低,质量改进或患者满意度混为一谈,但这些努力(尽管很重要)与价值不同,后者主要侧重于改善患者的健康状况。对组织取得了更好的成果同时往往降低了成本的十年研究表明,基于价值的医疗保健实施战略框架应从识别和了解一部分患者的健康状况和相关情况创造出一致的需求开始。然后,一个跨学科的护理人员团队将共同设计并提供全面的解决方案,以满足这些需求。该团队评估了每位患者的健康结果和护理费用,并使用该信息来推动持续的改善。通过这种方式提供的护理可以使分娩与患者的健康状况保持一致,并使临床医生重新达到其作为治疗者的目的。它还要求医生对他们在大型护理团队中的角色以及该团队提供的服务有不同的看法。作者建议,医学院校应在整个本科医学课程中纳入基于价值的医疗保健的原则和实施方面的教育,以使他们的毕业生为进入医务人员队伍而引领向基于价值的医疗保健的转变。

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