Virzi L, Piziali L
Saint Vincent Hospital, Worcester, MA.
J Healthc Mater Manage. 1994 Jul;12(7):24, 28-9, 32.
Over the last ten years, separate and repeated attempts by Cardiology Management, Materials Management, and physicians to effectively reduce pacemaker costs had led to limited successes of short duration. Issues of physician choice, clinical application of advancing technology and long-term relationships with a variety of vendor representatives had usually conspired to overwhelm any incremental inroads into manufacturers' pricing structures. A collaborative review of past practices resulted in the creation of a multi-disciplinary task force charged with two goals: maintain physician choice and reduce costs. In the resulting process, no manufacturer was eliminated, vendors accepted all of the risks and received no guarantees of market share, and device specifications were matched to clinical indications in a preferred device matrix. The task force met both of its goals as evidenced by a 18.9% decrease in annual expenditures for pacemakers and by a 27% shift in device use based upon physician choice.
在过去十年里，心脏病管理部门、材料管理部门以及医生各自反复尝试有效降低起搏器成本，但成效有限且持续时间短。医生的选择、先进技术的临床应用以及与各类供应商代表的长期关系等问题，通常共同作用，使得在制造商定价结构方面取得的任何渐进式进展都被抵消。对过去做法进行协作审查后，成立了一个多学科特别工作组，该工作组有两个目标：维持医生的选择并降低成本。在最终形成的流程中，没有淘汰任何制造商，供应商承担了所有风险且未获得市场份额的保证，并且在首选设备矩阵中将设备规格与临床适应症进行了匹配。特别工作组实现了其两个目标，这体现在起搏器年度支出下降了18.9%，以及基于医生选择的设备使用发生了27%的转变。
