American College of Physicians, 190 N. Independence Mall West, Philadelphia, PA 19106, USA.
Ann Intern Med. 2012 Aug 21;157(4):284-6. doi: 10.7326/0003-4819-157-4-201208210-00496.
Health care expenditures are projected to reach nearly 20% of the U.S. gross domestic product by 2020. Up to $765 billion of this spending has been identified as potentially avoidable; many of the avoidable costs have been attributed to unnecessary services. Postgraduate trainees have historically received little specific training in the stewardship of health care resources and minimal feedback on resource utilization and its effect on the cost of care. This article describes a new curriculum that was developed collaboratively by the Alliance for Academic Internal Medicine and the American College of Physicians to address this training gap. The curriculum introduces a simple, stepwise framework for delivering high-value care and focuses on teaching trainees to incorporate high-value, cost-conscious care principles into their clinical practice. It consists of ten 1-hour, case-based, interactive sessions designed to be flexibly incorporated into the existing conference structure of a residency training program.
到 2020 年，预计医疗保健支出将占美国国内生产总值的近 20%。在这部分支出中，高达 7650 亿美元被认为是可以避免的；其中许多可避免的成本都归因于不必要的服务。研究生培训生在医疗资源管理方面接受的专门培训历来很少，对资源利用及其对医疗成本的影响也很少得到反馈。本文描述了由学术医学联盟和美国医师学院合作开发的一门新课程，以解决这一培训差距。该课程介绍了一个简单的、逐步的提供高价值医疗服务的框架，并侧重于培训学员将高价值、有成本意识的医疗原则纳入他们的临床实践中。该课程由十个 1 小时的、基于案例的、互动式的课程组成，旨在灵活地融入住院医师培训计划现有的会议结构中。
