Chung Kevin C, Swanson Jennifer A, Schmitz DeLaine, Sullivan Daniel, Rohrich Rod J
Ann Arbor, Mich.; Arlington Heights, Ill.; and Dallas, Texas From the Section of Plastic Surgery, Department of Surgery, University of Michigan Health System; the Department of Plastic Surgery, University of Texas Southwestern Medical Center; and the American Society of Plastic Surgeons.
Plast Reconstr Surg. 2009 Apr;123(4):1385-1389. doi: 10.1097/PRS.0b013e31819f25ff.
An effective healthcare system is one in which healthcare spending provides acceptable returns in terms of health outcomes and broad coverage for its citizens. By this measure, the United States healthcare system unfortunately falls short. Tremendous pressure for improvement has given rise to several initiatives designed to decrease healthcare expenditure and improve outcomes, access, and quality of care. The outcomes movement, which is revolutionary in American medicine, has heightened awareness about the need to critically examine our treatment outcomes. However, the early euphoria surrounding the outcomes movement was met with restraint at the realization of its limitations. Although the outcomes movement has verified the effectiveness of many existing treatments in plastic surgery, most of the investments in these projects unfortunately have resulted in few, if any, positive changes for the patient, physician or healthcare system (1). US healthcare is now moving towards the adoption of evidence-based medicine (EBM), which may potentially be another revolution in American healthcare (2).
医疗支出能在健康结果方面带来可接受的回报，并为其公民提供广泛的覆盖范围。从这个标准来看，不幸的是美国医疗体系有所欠缺。巨大的改进压力催生了多项旨在降低医疗支出并改善结果、医疗可及性和医疗质量的举措。在美国医学领域具有革命性的结果运动，提高了人们对严格审视我们治疗结果必要性的认识。然而，围绕结果运动最初的欣喜在意识到其局限性后有所收敛。尽管结果运动已经证实了许多现有整形手术治疗方法的有效性，但不幸的是，这些项目中的大部分投资对患者、医生或医疗体系几乎没有带来任何积极变化（如果有变化的话）(1)。美国医疗目前正朝着采用循证医学（EBM）的方向发展，这可能会成为美国医疗领域的又一次革命(2)。
