Temple University School of Medicine, Philadelphia, Pennsylvania, USA.
Ann Intern Med. 2012 Jan 17;156(2):147-9. doi: 10.7326/0003-4819-156-2-201201170-00011.
Unsustainable rising health care costs in the United States have made reducing costs while maintaining high-quality health care a national priority. The overuse of some screening and diagnostic tests is an important component of unnecessary health care costs. More judicious use of such tests will improve quality and reflect responsible awareness of costs. Efforts to control expenditures should focus not only on benefits, harms, and costs but on the value of diagnostic tests-meaning an assessment of whether a test provides health benefits that are worth its costs or harms. To begin to identify ways that practicing clinicians can contribute to the delivery of high-value, cost-conscious health care, the American College of Physicians convened a workgroup of physicians to identify, using a consensus-based process, common clinical situations in which screening and diagnostic tests are used in ways that do not reflect high-value care. The intent of this exercise is to promote thoughtful discussions about these tests and other health care interventions to promote high-value, cost-conscious care.
美国医疗保健成本的持续增长已成为一个国家的首要任务，如何在控制成本的同时维持高质量的医疗保健。过度使用某些筛查和诊断测试是不必要的医疗保健费用的一个重要组成部分。更明智地使用这些测试将提高医疗质量并反映出对成本的负责任意识。控制支出的努力不仅应着眼于收益、危害和成本，还应着眼于诊断测试的价值——这意味着评估测试是否提供了值得其成本或危害的健康收益。为了开始确定执业临床医生如何为提供高价值、有成本意识的医疗保健做出贡献，美国医师学院召集了一组医生，使用基于共识的流程，确定在哪些常见临床情况下，筛查和诊断测试的使用方式没有体现高价值的医疗保健。这项工作的目的是促进对这些测试和其他医疗保健干预措施的深思熟虑的讨论，以促进高价值、有成本意识的护理。
