Paganoni Sabrina, Nicholson Katie, Leigh Fawn, Swoboda Kathryn, Chad David, Drake Kristin, Haley Kellen, Cudkowicz Merit, Berry James D
Harvard Medical School, Department of Neurology, Massachusetts General Hospital (MGH), Boston, Massachusetts, USA.
Neurological Clinical Research Institute (NCRI), Massachusetts General Hospital, Boston, Massachusetts, USA.
Muscle Nerve. 2017 Nov;56(5):848-858. doi: 10.1002/mus.25725. Epub 2017 Aug 29.
Multidisciplinary care is considered the standard of care for both adult and pediatric neuromuscular disorders and has been associated with improved quality of life, resource utilization, and health outcomes. Multidisciplinary care is delivered in multidisciplinary clinics that coordinate care across multiple specialties by reducing travel burden and streamlining care. In addition, the multidisciplinary care setting facilitates the integration of clinical research, patient advocacy, and care innovation (e.g., telehealth). Yet, multidisciplinary care requires substantial commitment of staff time and resources. We calculated personnel costs in our ALS clinic in 2015 and found an average cost per patient visit of $580, of which only 45% was covered by insurance reimbursement. In this review, we will describe classic and emerging concepts in multidisciplinary care models for adult and pediatric neuromuscular disease. We will then explore the financial impact of multidisciplinary care with emphasis on sustainability and metrics to demonstrate quality and value. Muscle Nerve 56: 848-858, 2017.
多学科护理被视为成人和儿童神经肌肉疾病护理的标准，并且与生活质量的改善、资源利用和健康结果相关。多学科护理在多学科诊所提供，这些诊所通过减轻出行负担和简化护理来协调多个专科的护理。此外，多学科护理环境有助于临床研究、患者宣传和护理创新（如远程医疗）的整合。然而，多学科护理需要工作人员投入大量的时间和资源。我们计算了2015年我们肌萎缩侧索硬化症诊所的人员成本，发现每次患者就诊的平均成本为580美元，其中只有45%由保险报销覆盖。在本综述中，我们将描述成人和儿童神经肌肉疾病多学科护理模式中的经典和新兴概念。然后，我们将探讨多学科护理的财务影响，重点是可持续性以及用于证明质量和价值的指标。《肌肉与神经》56: 848 - 858, 2017年。
