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2013 | nr 1 | 4--25
Tytuł artykułu

Reengineering Health Care: Questionable Medical Tests and Procedures

Warianty tytułu
Języki publikacji
EN
Abstrakty
EN
Given current and future budgetary constraints, issues of what constitute appropriate level of care are becoming paramount. More evidence-based data are accumulated, identifying the appropriate use of medical tests and procedures becomes imperative. In the United States, the "Choosing Wisely" campaign is an initiative of the American Board of Internal Medicine Foundation to allow physicians to be leaders in better management of fi nite health care resources. As part of a campaign, each participating medical specialty society has created lists of "Things Physicians and Patients Should Question" that provide specific, evidence-based recommendations, so physicians and patients can reach informed decisions about the appropriate level of care. Here we provide the summary of the most important recommendations. The aim of this paper is to disseminate the information in order to stimulate discussions about the appropriateness of frequently ordered tests or treatments and about variations in patterns of care, and cost-eff ective ways of managing fi nite health care resources. Central to the best practice of medicine becomes comparative-effectiveness research, including long term studies on clinical benefi ts and costs. Physicians must change practice patterns, through standard-of-practice guidelines, to practice in the most knowledge-based, least invasive, and less costly way. Physicians need to take a leadership role in teaching patients that more medicine is not better medicine, that costly eff orts do not equal better health care. We need to explain to patients that new medical technology must be used with care and wisdom. (original abstract)
Słowa kluczowe
Rocznik
Numer
Strony
4--25
Opis fizyczny
Twórcy
autor
  • McGill University, Montreal, Canada
autor
  • Zowall Consulting Inc. Health Economics and Outcomes Research, Montreal, Canada
  • McGill University, Montreal , Canada
Bibliografia
  • Emanuel E., Tanden N., Altman S., Armstrong S., Berwick D., de Brantes F., Calsyn M., Chernew M., Colmers J., Cutler D., Daschle T., Egerman P., Kocher B., Milstein A., Oshima Lee E., Podesta JD., Reinhardt U., Rosenthal M., Sharfstein J., Shortell S., Stern A., Orszag PR., Spiro T. A systemic approach to containing health care spending. N Engl J Med. 2012 Sep 6; 367(10): 949-54
  • Lipitz-Snyderman A., Bach PB. Overuse of Health Care Services: When Less Is More . . . More or Less. JAMA Intern Med. 2013 May 27: 1-2
  • Chien Alyna T., Rosenthal Meredith B. Waste Not, Want Not: Promoting Efficient Use of Health Care Resources. Annals of Internal Medicine. 2013 Jan; 158(1): 67-68
  • Berwick DM., Hackbarth AD. Eliminating waste in US health care. JAMA. 2012 Apr 11; 307(14): 1513-6. doi: 10.1001/jama.2012.362. Epub 2012 Mar 14
  • Qaseem A., Alguire P., Dallas P., Feinberg L.E., Fitzgerald FT., Horwitch C., Humphrey L., LeBlond R., Moyer D., Wiese JG., Weinberger S. Appropriate use of screening and diagnostic tests to foster high-value, cost-conscious care. Ann Intern Med. 2012 Jan 17; 156(2): 147-9
  • ABIM Foundation: Choosing Wisely. 2012
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  • Korenstein D., Falk R., Howell EA., Bishop T., Keyhani S. Overuse of health care services in the United States: an understudied problem. Arch Intern Med 2012; 172(2): 171-178
  • Welch HG., Schwartz I., Woloshin S. Overdiagnosed-making people sick in the pursuit of health. Beacon Press; Boston, MA; 2011
  • Constant A., Peterson S., Mallory CD., Major J. Research synthesis on cost drivers in the health sectors and proposed policy options. Canadian Health Service Research Foundation; Ottawa, ON; 2011
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  • Fenton JJ., Jerant AF., Bertakis KD., Franks P. The cost of satisfaction: a national study of patient satisfaction, health care utilization, expenditures, and mortality. Arch Intern Med 2012; 172(5): 405-411
  • Palfrey S. Daring to practice low-cost medicine in a high-tech era. N Engl J Med 2011; 364(11): e21
  • Brook RH. Do physicians need a shopping cart for health care services? JAMA 2012; 307(8): 791-792
  • Britten N., Ukoumunne O.: The influence of patients' hopes of receiving a prescription on doctors' perceptions and the decision to prescribe: a questionnaire survey. BMJ. 1997; 315(7121): 1506-1510
  • Cockburn J., Pit S. Prescribing behaviour in clinical practice: patients' expectations and doctors' perceptions of patients' expectations-a questionnaire study. BMJ. 1997; 315(7107): 520-523
  • Stivers T., Mangione-Smith R., Elliott MN., McDonald L., Heritage J. Why do physicians think parents expect antibiotics? What parents report vs. what physicians believe. J Fam Pract. 2003; 52(2): 140-148
  • Mangione-Smith R., McGlynn EA., Elliott MN., McDonald L., Franz CE., Kravitz RL.: Parent expectations for antibiotics, physician-parent communication, and satisfaction. Arch Pediatr Adolesc Med. 2001; 155(7): 800-806
  • Altiner A., Brockmann S., Sielk M., Wilm S., Wegscheider K., Abholz HH. Reducing antibiotic prescriptions for acute cough by motivating GPs to change their attitudes to communication and empowering patients: a cluster-randomized intervention study. J Antimicrob Chemother. 2007; 60(3): 638-644
  • Gwyn R., Elwyn G. When is a shared decision not (quite) a shared decision? Negotiating preferences in a general practice encounter. Soc Sci Med. 1999; 49 (4): 437-447
Typ dokumentu
Bibliografia
Identyfikatory
Identyfikator YADDA
bwmeta1.element.ekon-element-000171479025

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