Woolf S H
Office of Disease Prevention and Health Promotion, Washington, DC 20201.
Arch Intern Med. 1990 Sep;150(9):1811-8.
There is growing interest in the use of practice guidelines for physicians as a means of reducing inappropriate care, controlling geographic variations in practice patterns, and making more effective use of health care resources. Recent developments at the national health policy level suggest that practice guidelines will play an increasingly prominent role in the practice of medicine. The federal government has created a new US Public Health Service agency with responsibility for practice guidelines. Guidelines have been developed by more than 35 physician organizations and specialty societies. The American Medical Association and the Council of Medical Specialty Societies have endorsed practice guidelines and are organizing specialty societies to set policy on the subject. Academic medical centers have formed a research consortium on practice guidelines. Independent research centers (eg, the RAND Corporation and the Institute of Medicine) are developing methods for assessing appropriateness and setting guidelines. Other groups, such as hospitals, insurers, managed care plans, and private enterprises, are also directly involved. The implications of these developments are far reaching.
人们越来越关注将医师实践指南作为减少不适当医疗、控制医疗模式地域差异以及更有效利用医疗资源的一种手段。国家卫生政策层面的最新进展表明，实践指南在医学实践中将发挥越来越重要的作用。联邦政府已设立了一个新的美国公共卫生服务机构，负责实践指南相关事务。超过35个医师组织和专业协会已制定了指南。美国医学协会和医学专业协会理事会已认可实践指南，并正在组织专业协会制定该主题的政策。学术医疗中心已成立了一个关于实践指南的研究联盟。独立研究中心（如兰德公司和医学研究所）正在开发评估适宜性和制定指南的方法。其他团体，如医院、保险公司、管理式医疗计划和私营企业，也直接参与其中。这些发展的影响意义深远。
