Berman S
Jt Comm J Qual Improv. 1999 Aug;25(8):434-9. doi: 10.1016/s1070-3241(16)30457-6.
More than 200 health care policymakers and researchers, clinicians, quality professionals, and other representatives of managed care organizations, government, and academia, attended the fifth annual Building Bridges conference, "The Health Care Puzzle: Using Research to Bridge the Gap Between Perception and Reality," in Chicago, April 11-13, 1999. Sponsored by the American Association of Health Plans and the Agency for Health Care Policy and Research--and now, the Centers for Disease Control and Prevention--these annual conferences are intended to promote research in measuring the quality and effectiveness of the services health plans provide. Selected plenary sessions from the conference are represented in this report.
"Three worthy objectives" for managed care-harmonize practice guidelines, develop evidence-based copays or price structure for drugs, and demystify medical necessity--were discussed. PLENARY: A POPULATION HEALTH PERSPECTIVE: Population-based care is designed to identify effective clinical and service interventions and ensure their efficient delivery, identify ineffective interventions and minimize their use, and monitor outcomes and change practice if outcomes are suboptimal. Yet certain questions need to be asked about how to put this strategy in place, especially Why should any individual or potential patient be willing to be treated in a population-based delivery system?
The concepts of scientific evidence and financial evidence for prevention were reviewed and applied in scenarios of the effectiveness and cost-effectiveness of selected preventive care services. Education efforts are needed to promote the use of effective interventions and encourage questioning of interventions with unproven or less important effectiveness and poor cost-effectiveness.
200多名医疗保健政策制定者、研究人员、临床医生、质量专业人员以及管理式医疗组织、政府和学术界的其他代表参加了1999年4月11日至13日在芝加哥举行的第五届年度“搭建桥梁”会议，即“医疗保健谜题：利用研究弥合认知与现实之间的差距”。这些年度会议由美国健康计划协会以及医疗保健政策与研究机构（现疾病控制与预防中心）主办，旨在促进对衡量健康计划所提供服务的质量和有效性的研究。本报告展示了会议中部分全会的内容。
讨论了管理式医疗的“三个重要目标”——协调实践指南、制定基于证据的药品自付费用或价格结构以及使医疗必要性不再神秘。
基于人群的健康视角：基于人群的医疗旨在确定有效的临床和服务干预措施并确保其高效实施，识别无效干预措施并尽量减少其使用，以及监测结果并在结果不理想时改变实践。然而，关于如何实施这一策略，还需要提出某些问题，特别是为什么任何个人或潜在患者愿意在基于人群的医疗服务系统中接受治疗？
回顾了预防的科学证据和财务证据的概念，并将其应用于选定预防保健服务的有效性和成本效益的情景中。需要开展教育工作，以促进有效干预措施的使用，并鼓励对那些有效性未经证实或不太重要且成本效益不佳的干预措施提出质疑。
