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疾病管理伙伴关系测量模型的经济影响:改善新斯科舍省的心血管结局(ICONS)。

The economic impact of a partnership-measurement model of disease management: Improving Cardiovascular Outcomes in Nova Scotia (ICONS).

作者信息

Crémieux Pierre-Yves, Fortin Pierre, Meilleur Marie-Claude, Montague Terrence, Royer Jimmy

机构信息

Analysis Group Inc.

出版信息

Healthc Q. 2007;10(2):38-46. doi: 10.12927/hcq.2007.18794.

Abstract

Improving Cardiovascular Outcomes in Nova Scotia (ICONS) was a five-year, community partnership-based disease-management project that sought, as a primary goal, to improve the care and outcomes of patients with heart disease in Nova Scotia. This program, based on a broad stakeholder partnership, provided repeated measurement and feedback on practices and outcomes as well as widespread communication and education among all partners. From a clinical viewpoint, ICONS was successful. For example, use of proven therapies for the target diseases improved and re-hospitalization rates decreased. Stakeholders also perceived a sense of satisfaction because of their involvement in the partnership. However, the universe of health stakeholders is large, and not many have had an experience similar to ICONS. These other health stakeholders, such as decision-makers concerned with the cost of care and determining the value for cost, might, nonetheless, benefit from knowledge of the ICONS concepts and results, particularly economic analyses, as they determine future health policy. Using budgetary data on actual dollars spent and a robust input-output methodology, we assessed the economic impact of ICONS, including trickle-down effects on the Canadian and Nova Scotian economies. The analysis revealed that the $6.22 million invested in Nova Scotia by the private sector donor generated an initial net increase in total Canadian wealth of $5.32 million and a global net increase in total Canadian wealth of $10.23 million, including $2.27 million returned to the different governments through direct and indirect taxes. Thus, the local, provincial and federal governments are important beneficiaries of health project investments such as ICONS. The various government levels benefit from the direct influx of private funds into the publicly funded healthcare sector, from direct and indirect tax revenues and from an increase in knowledge-related employment. This, of course, is in addition to the clinical benefits associated with the partnership-measurement disease-management model. Because of their uniquely simultaneous roles as beneficiary and major resource provider, the public payer can play an early and active role in such partnerships to enhance its efficiencies and increase the likelihood of sustainability if the original concepts are proven of value.

摘要

新斯科舍省改善心血管结局项目(ICONS)是一个为期五年、基于社区伙伴关系的疾病管理项目,其首要目标是改善新斯科舍省心脏病患者的护理和结局。该项目基于广泛的利益相关者伙伴关系,对实践和结局进行反复衡量与反馈,并在所有伙伴之间进行广泛的沟通和教育。从临床角度来看,ICONS项目取得了成功。例如,针对目标疾病的经证实疗法的使用有所改善,再住院率下降。利益相关者也因参与该伙伴关系而感到满意。然而,健康领域的利益相关者群体庞大,并非很多人都有类似ICONS项目的经历。这些其他健康利益相关者,比如关注护理成本和确定成本价值的决策者,在制定未来卫生政策时,可能会从ICONS项目的理念和成果,尤其是经济分析中受益。我们利用实际支出的预算数据和强大的投入产出方法,评估了ICONS项目的经济影响,包括对加拿大和新斯科舍省经济的涓滴效应。分析表明,私营部门捐赠者在新斯科舍省投资的622万加元使加拿大总财富初步净增加532万加元,加拿大总财富全球净增加1023万加元,其中包括通过直接和间接税收返还给不同政府的227万加元。因此,地方、省级和联邦政府是ICONS等卫生项目投资的重要受益者。各级政府受益于私人资金直接流入公共资助的医疗保健部门、直接和间接税收收入以及与知识相关就业的增加。当然,这还不包括与伙伴关系衡量疾病管理模式相关的临床益处。由于公共支付者独特地同时扮演着受益者和主要资源提供者的角色,它可以在此类伙伴关系中发挥早期和积极作用,以提高其效率,并在原始理念被证明有价值的情况下增加可持续性的可能性。

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