Cave D G
Hewitt Associates, Newport Beach, CA.
J Ambul Care Manage. 1994 Jul;17(3):15-36. doi: 10.1097/00004479-199407000-00006.
For many large physician groups, about 75% of all revenues come from capitation contracts. These groups may reduce the variable expenses of patient care by conducting medical outcome studies. Physician groups will obtain the most benefit for their limited research dollars by focusing outcomes research on prevalent medical conditions. The purpose of this study is to provide a comprehensive analysis of the content of physicians' medical practices. We found that 21 diagnostic clusters defined 70% or more of the episodes treated by primary care physicians. For specialists, no more than eight diagnostic clusters were needed to define the majority of their practices. Outcomes research should initially focus on abdominal pain, acute lower respiratory infections, cataracts, cholelithiasis, congestive heart failure, diabetes mellitus, external abdominal hernias, ischemic heart disease, low back pain, maternity care, menstrual disorders, otitis media, peptic diseases, prostate cancer, psychotic episodes, renal calculi, seizure disorders, and thyroid diseases.
对于许多大型医生团体而言，所有收入的约75%来自按人头付费合同。这些团体可以通过开展医学结果研究来降低患者护理的可变费用。医生团体通过将结果研究集中在常见病症上，将从其有限的研究资金中获得最大收益。本研究的目的是对医生医疗实践的内容进行全面分析。我们发现，21个诊断类别涵盖了初级保健医生治疗的70%或更多病例。对于专科医生来说，定义其大多数医疗实践所需的诊断类别不超过8个。结果研究最初应关注腹痛、急性下呼吸道感染、白内障、胆石症、充血性心力衰竭、糖尿病、腹外疝、缺血性心脏病、腰痛、产科护理、月经紊乱、中耳炎、消化系统疾病、前列腺癌、精神病发作、肾结石、癫痫症和甲状腺疾病。
