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审视美国医疗体系的质量与效率。

Examining quality and efficiency of the U.S. healthcare system.

作者信息

Kumar Sameer, Ghildayal Neha S, Shah Ronak N

机构信息

Opus College of Business, University of St. Thomas, Minneapolis, Minnesota, USA.

出版信息

Int J Health Care Qual Assur. 2011;24(5):366-88. doi: 10.1108/09526861111139197.

Abstract

PURPOSE

The fundamental concern of this research study is to learn the quality and efficiency of U.S. healthcare services. It seeks to examine the impact of quality and efficiency on various stakeholders to achieve the best value for each dollar spent for healthcare. The study aims to offer insights on quality reformation efforts, contemporary healthcare policy and a forthcoming change shaped by the Federal healthcare fiscal policy and to recommend the improvement objective by comparing the U.S. healthcare system with those of other developed nations.

DESIGN/METHODOLOGY/APPROACH: The US healthcare system is examined utilizing various data on recent trends in: spending, budgetary implications, economic indicators, i.e., GDP, inflation, wage and population growth. Process maps, cause and effect diagrams and descriptive data statistics are utilized to understand the various drivers that influence the rising healthcare cost. A proposed cause and effect diagram is presented to offer potential solutions, for significant improvement in U.S. healthcare.

FINDINGS

At present, the US healthcare system is of vital interest to the nation's economy and government policy (spending). The U.S. healthcare system is characterized as the world's most expensive yet least effective compared with other nations. Growing healthcare costs have made millions of citizens vulnerable. Major drivers of the healthcare costs are institutionalized medical practices and reimbursement policies, technology-induced costs and consumer behavior.

PRACTICAL IMPLICATIONS

Reviewing many articles, congressional reports, internet websites and related material, a simplified process map of the US healthcare system is presented. The financial process map is also created to further understand the overall process that connects the stakeholders in the healthcare system. Factors impacting healthcare are presented by a cause and effect diagram to further simplify the complexities of healthcare. This tool can also be used as a guide to improve efficiency by removing the "waste" from the system. Trend analyses are presented that display the crucial relationship between economic growth and healthcare spending.

ORIGINALITY/VALUE: There are many articles and reports published on the US healthcare system. However, very few articles have explored, in a comprehensive manner, the links between the economic indicators and measures of the healthcare system and how to reform this system. As a result of the US healthcare system's complex structure, process map and cause-effect diagrams are utilized to simplify, address and understand. This study linked top-level factors, i.e., the societal, government policies, healthcare system comparison, potential reformation solutions and the enormity of the recent trends by presenting serious issues associated with U.S. healthcare.

摘要

目的

本研究的根本关注点在于了解美国医疗服务的质量和效率。它试图考察质量和效率对各类利益相关者的影响,以便在医疗保健方面每花费一美元都能实现最佳价值。该研究旨在为质量改革努力、当代医疗政策以及由联邦医疗财政政策塑造的即将到来的变革提供见解,并通过将美国医疗体系与其他发达国家的医疗体系进行比较,推荐改进目标。

设计/方法/途径:利用关于支出、预算影响、经济指标(即国内生产总值、通货膨胀、工资和人口增长)等近期趋势的各种数据对美国医疗体系进行考察。使用流程图、因果图和描述性数据统计来理解影响医疗成本不断上升的各种驱动因素。提出了一个因果图以提供潜在的解决方案,从而显著改善美国的医疗保健。

研究结果

目前,美国医疗体系对国家经济和政府政策(支出)至关重要。与其他国家相比,美国医疗体系的特点是世界上最昂贵但效率最低。不断增长的医疗成本使数百万公民变得脆弱。医疗成本的主要驱动因素是制度化的医疗实践和报销政策、技术引发的成本以及消费者行为。

实际意义

通过查阅众多文章、国会报告、互联网网站及相关资料,呈现了美国医疗体系的简化流程图。还创建了财务流程图,以进一步理解连接医疗体系中利益相关者的整体过程。通过因果图展示影响医疗保健的因素,以进一步简化医疗保健的复杂性。该工具还可作为一种指南,通过消除系统中的“浪费”来提高效率。呈现了趋势分析,展示了经济增长与医疗支出之间的关键关系。

原创性/价值:关于美国医疗体系已发表了许多文章和报告。然而,很少有文章全面探讨经济指标与医疗体系衡量标准之间的联系以及如何改革该体系。由于美国医疗体系结构复杂,则利用流程图和因果图来进行简化、处理和理解。本研究通过呈现与美国医疗保健相关的严重问题,将顶级因素(即社会、政府政策、医疗体系比较、潜在改革解决方案以及近期趋势的严重性)联系起来。

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