Dartmouth-Hitchcock Medical Center, USA.
Health Aff (Millwood). 2012 Jun;31(6):1329-38. doi: 10.1377/hlthaff.2011.0935. Epub 2012 May 9.
Members of a consortium of leading US health care systems, known as the High Value Healthcare Collaborative, used administrative data to examine differences in their delivery of primary total knee replacement. The goal was to identify opportunities to improve health care value by increasing the quality and reducing the cost of that procedure. The study showed substantial variations across the participating health care organizations in surgery times, hospital lengths-of-stay, discharge dispositions, and in-hospital complication rates. The study also revealed that higher surgeon caseloads were associated with shorter lengths-of-stay and operating time, as well as fewer in-hospital complications. These findings led the consortium to test more coordinated management for medically complex patients, more use of dedicated teams, and a process to improve the management of patients' expectations. These innovations are now being tried by the consortium's members to evaluate whether they increase health care value.
一个由美国领先的医疗保健系统组成的联盟成员，称为高价值医疗保健合作组织，使用管理数据来检查他们提供初级全膝关节置换术的差异。目的是通过提高该手术的质量并降低成本来提高医疗保健的价值。该研究表明，参与的医疗保健组织在手术时间、住院时间、出院安排和住院并发症发生率方面存在很大差异。该研究还表明，更高的外科医生手术量与较短的住院时间和手术时间以及较少的院内并发症相关。这些发现促使该联盟测试更协调的管理方法，以管理医疗复杂的患者，更多地使用专门的团队，并建立一个流程来改善患者期望的管理。这些创新措施正在由该联盟的成员进行测试，以评估它们是否增加医疗保健的价值。
