Child and Newborn Health Group, KEMRI/Wellcome Trust and School of Economics, Kenyattta University, P,O, box 43844, 00100 GPO, Nairobi, Kenya.
Health Res Policy Syst. 2011 Jun 16;9:24. doi: 10.1186/1478-4505-9-24.
Clinician dependent costs are the costs of care that are under the discretion of the healthcare provider. These costs include the costs of drugs, tests and investigations, and discretionary outpatient visits and impatient stays. The purpose of this review was to summarize recent evidence, relevant to both developed and developing countries on whether evidence based clinical guidelines can change hospitals variable costs which are clinician dependent, and the degree of financial savings achieved at hospital level. Potential studies for inclusion were identified using structured searches of Econlit, J-Stor, and Pubmed databases. Two reviewers independently evaluated retrieved studies for inclusion. The methodological quality of the selected articles was assessed using the Oxford Centre for Evidence- Based Medicine (CEBM) levels of evidence. The results suggest that 10 of the 11 interventions were successful reducing financial costs. Most of the interventions, either in modeling studies or real interventions generate significant financial saving, although the former reported higher savings because the studies assumed 100 percent compliance.
临床医生相关成本是指在医疗保健提供者的自由裁量权下产生的医疗费用。这些成本包括药物、检查和调查的费用，以及可自由支配的门诊就诊和住院费用。本综述的目的是总结最近在发达国家和发展中国家都有相关的证据，即基于证据的临床指南是否可以改变医院可变成本，这些成本是由临床医生决定的，以及在医院层面实现的节省程度。使用结构化搜索 Econlit、J-Stor 和 Pubmed 数据库来确定潜在的纳入研究。两位评审员独立评估检索到的研究是否符合纳入标准。使用牛津循证医学中心（CEBM）证据水平评估方法评估选定文章的方法学质量。结果表明，11 项干预措施中有 10 项成功地降低了财务成本。大多数干预措施，无论是在模型研究还是实际干预中，都产生了显著的财务节约，尽管前者报告的节约更高，因为研究假设了 100%的合规性。
