Kernick David, Scott Anthony
St Thomas Health Centre, Exeter.
Br J Gen Pract. 2002 Jan;52(474):42-6.
Against a background of government calls for a radical change in the way the medical workforce is planned and trained, the concept of skill mix seeks to match clinical presentation to an intervention based on an appropriate level of skill and training. Health economics is not the only framework within which these changes can be analysed. However unless the economic issues are thought through clearly there is a danger that resources may be used inefficiently. The aims of this paper are to outline the economic issues in the area of doctor/nurse skill mix and the problems of obtaining correct solutions from the perspective of efficiency. It concludes by offering a pragmatic framework which can facilitate decisions in this area. Although this paper is written from the perspective of primary care, it is equally relevant to skill mix in the secondary care sector.
在政府呼吁对医疗劳动力的规划和培训方式进行彻底变革的背景下，技能组合的概念旨在根据适当的技能水平和培训，使临床表现与干预措施相匹配。卫生经济学并非分析这些变革的唯一框架。然而，除非清楚地思考经济问题，否则存在资源利用效率低下的风险。本文的目的是概述医生/护士技能组合领域的经济问题，以及从效率角度获得正确解决方案的问题。本文最后提供了一个务实的框架，以促进该领域的决策。尽管本文是从初级保健的角度撰写的，但它同样适用于二级保健部门的技能组合。
