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认清医疗成本的现实——拓宽医学教育中的成本管理视角
Getting Real about Health Care Costs — A Broader Approach to Cost Stewardship in Medical Education


Ravi B. Parikh ... 其他 • 2017.03.09

近年来,越来越多的医学院校已开始提供成本管理方面的培训,这是为了提高医疗价值而做出的各项努力中的一部分。但与患者的日常接触提醒我们在成本方面要清醒地意识到短视的医师教育会带来意想不到的后果。

让我们来考虑一位因心力衰竭加重而住院的88岁女性病例。待病情重新稳定后,她需要做一次超声心动图以评估心脏收缩功能障碍。受训医师团队讨论她是否应该为了接受检查而在医院多住一晚。主治医师决定让她出院,并在预约的随访中做超声心动图。他的理由:“门诊的成本会较少。”





作者信息

Ravi B. Parikh, M.D., M.P.P., Arnold Milstein, M.D., M.P.H., and Sachin H. Jain, M.D., M.B.A.
From Brigham and Women’s Hospital, Boston (R.B.P.); and Stanford University, Stanford (A.M., S.H.J.), and CareMore Health System, Cerritos (S.H.J.) — both in California.

 

参考文献

1. Association of American Medical Colleges. Number of medical schools including topic in required courses and elective courses: costs of care (https://www.aamc.org/initiatives/cir/406462/06a.html).

2. Riegelman R. Commentary: health systems and health policy: a curriculum for all medical students. Acad Med 2006;81:391-392

3. Moriates C, Dohan D, Spetz J, Sawaya GF. Defining competencies for education in health care value: recommendations from the University of California, San Francisco Center for Healthcare Value Training Initiative. Acad Med 2015;90:421-424

4. Stammen LA, Stalmeijer RE, Paternotte E, et al. Training physicians to provide high-value, cost-conscious care: a systematic review. JAMA 2015;314:2384-2400

5. iGioia AM III, Greenhouse PK. Creating value with the patient- and family-centered care methodology and practice: what trainees need to know, why, and strategies for medical education. AMA J Ethics 2016;18:33-39

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