Hongsermeier T
InterQual, Inc., Marlborough, MA 01752, USA.
Med Group Manage J. 1997 Jul-Aug;44(4):28-30, 32, 75.
Patients and physicians are wary that managed care will unnecessarily limit access to specialists. At the same time, there is a recognized need to control medical costs. Clinical decision support criteria can help group practices achieve balance between clinical protocol and cost management. They help protect against over- and underutilization of resources, including specialist care. They also help physicians justify care decisions to the patient and to the health plan providing payment.
患者和医生担心管理式医疗会不必要地限制患者获得专科医生服务的机会。与此同时，人们也意识到有必要控制医疗成本。临床决策支持标准有助于团体医疗实践在临床规范和成本管理之间取得平衡。它们有助于防止资源的过度利用和利用不足，包括专科护理资源。它们还帮助医生向患者和提供支付的健康计划证明护理决策的合理性。
