Rundell Sean D, Goode Adam P, Friedly Janna L, Jarvik Jeffrey G, Sullivan Sean D, Bresnahan Brian W
S.D. Rundell, PT, DPT, PhD, Department of Rehabilitation Medicine, University of Washington, Box 359455, 4333 Brooklyn Ave NE, Seattle, WA 98105 (USA), and Comparative Effectiveness, Cost, and Outcomes Research Center, University of Washington.
A.P. Goode, PT, DPT, PhD, Doctor of Physical Therapy Division, Duke University, Durham, North Carolina.
Phys Ther. 2015 Dec;95(12):1703-11. doi: 10.2522/ptj.20150033. Epub 2015 Aug 27.
The concept of value is receiving greater attention in rehabilitation and the broader health care environment. The overall purpose of this article is to present a framework to help clinicians, researchers, educators, and policy makers better understand the role of health services research in developing and evaluating evidence on value in rehabilitation. Value in health care is a multidimensional concept and may be defined differently by various stakeholders, but assessing value typically involves considering a combination of several health and economic outcomes. However, health care stakeholders often lack sufficient information on these outcomes to make well-informed decisions. Health services approaches such as comparative effectiveness research, patient-centered outcomes research, and health economics assessments are some ways to evaluate value. The evidence generated from such studies directly informs decision making and health policy. Rehabilitation professionals have a great opportunity to increase their engagement in describing, evaluating, delivering, and disseminating high-value care, but there are several barriers they need to consider to be most successful. Embracing health services research best practices is essential for advancing appropriate rehabilitation practice, research, and policy and for addressing challenges to implementing high-value care.
价值概念在康复领域以及更广泛的医疗环境中受到越来越多的关注。本文的总体目的是提出一个框架，以帮助临床医生、研究人员、教育工作者和政策制定者更好地理解卫生服务研究在制定和评估康复价值证据方面的作用。医疗保健中的价值是一个多维度概念，不同利益相关者可能有不同的定义，但评估价值通常需要综合考虑多个健康和经济结果。然而，医疗保健利益相关者往往缺乏关于这些结果的足够信息，难以做出明智的决策。比较效果研究、以患者为中心的结果研究和卫生经济学评估等卫生服务方法是评估价值的一些途径。此类研究产生的证据直接为决策和卫生政策提供依据。康复专业人员有很大的机会更多地参与描述、评估、提供和传播高价值护理，但要取得最大成功，他们需要考虑几个障碍。采用卫生服务研究的最佳实践对于推进适当的康复实践、研究和政策以及应对实施高价值护理的挑战至关重要。
