Dis Manag. 2003 Fall;6(3):121-38. doi: 10.1089/109350703322425473.
Disease management is conceptually recognized as being a significant approach for closing the gaps in care identified by the Institute of Medicine as contributing to poor outcomes from our health care system. That conceptual credibility has been bolstered by the disease management industry through the adoption of an industry-standard definition of disease management and through the development and implementation of disease management accreditation programs by the National Committee for Quality Assurance, Utilization Review Accreditation Commission, and Joint Commission on Accreditation of Healthcare Organizations. The clinical and financial outcomes of disease management programs continue to be suspect, however, due to the lack of an industry standard set of outcomes metrics and a uniform methodology for evaluating those metrics. As a result, the ability to evaluate the effectiveness of any individual program is compromised, and the ability to effectively compare results across programs of different delivery designs is non-existent. To address this issue, American Healthways and Johns Hopkins convened a consensus conference of nearly 150 health care professionals representing health plans, hospitals, practicing physicians (both primary care and specialty), and other health care professionals. The conference purpose was to develop a "first-step" set of metrics and a uniform methodology that could be applied industry-wide to enable meaningful comparisons between programs and to allow evaluation of individual programs whether "homegrown" or "outsourced." The consensus conferees recognized that there were many paths to this objective, but that they had to land on a set of metrics and a methodology that was "doable" in light of today's technology and data availability. The results of their consensus effort follow.
疾病管理在概念上被视为一种重要方法，用于弥合医学研究所确定的医疗保健差距，这些差距导致我们的医疗保健系统产生不良后果。疾病管理行业通过采用疾病管理的行业标准定义，以及通过国家质量保证委员会、利用审查认证委员会和医疗保健组织认证联合委员会制定和实施疾病管理认证计划，增强了这种概念上的可信度。然而，由于缺乏一套行业标准的结果指标和评估这些指标的统一方法，疾病管理计划的临床和财务结果仍然受到质疑。因此，评估任何单个计划有效性的能力受到损害，并且不存在有效比较不同交付设计的计划结果的能力。为了解决这个问题，美国健康之路公司和约翰霍普金斯大学召集了一次由近150名医疗保健专业人员组成的共识会议，这些专业人员代表了健康计划、医院、执业医生（包括初级保健和专科医生）以及其他医疗保健专业人员。会议的目的是制定一套“第一步”指标和统一方法，可在全行业应用，以便在计划之间进行有意义的比较，并允许评估单个计划，无论其是“自主开发的”还是“外包的”。达成共识的与会者认识到实现这一目标有许多途径，但他们必须根据当今的技术和数据可用性，确定一套可行的指标和方法。他们达成共识的努力结果如下。
