Institute for Healthcare Optimization, Newton, Massachusetts, USA.
Health Aff (Millwood). 2011 Jan;30(1):76-80. doi: 10.1377/hlthaff.2010.1114.
A major issue for the US health care system will be accommodating the needs of the estimated thirty-two million Americans who will gain insurance coverage under the Affordable Care Act by 2019. For hospitals, a traditional response to this increased demand might be to add resources, such as more staff and beds. We argue that such actions would be unaffordable and unnecessary. Research has demonstrated that large gains in efficiency can be made through streamlining patient flow and redesigning care processes. We argue that once managed efficiently, US hospitals, on average, could achieve at least an 80-90 percent bed occupancy rate--at least 15 percent higher than the current level--without adding beds at capital costs of approximately $1 million per bed. This article outlines a plan for hospitals to accommodate more patients without increasing beds or staff, and for policy makers to require hospitals to make these changes or provide incentives for them to do so.
美国医疗体系面临的一个主要问题是如何满足预计到 2019 年将通过《平价医疗法案》获得医疗保险的 3200 万美国人的需求。对于医院来说，应对这种需求增加的传统方法可能是增加资源，如更多的员工和床位。我们认为，这些措施将是负担不起的，也是没有必要的。研究表明，通过简化患者流程和重新设计护理流程，可以实现效率的大幅提高。我们认为，一旦得到有效管理，美国医院的床位入住率平均可以提高至少 15%，达到 80%到 90%以上，而无需以每张床位约 100 万美元的资本成本增加床位。本文概述了一项计划，旨在让医院在不增加床位或员工的情况下容纳更多的病人，并要求政策制定者让医院做出这些改变，或为其做出改变提供激励。
