McQuillen Daniel P, MacIntyre Ann T
Center for Infectious Diseases and Prevention, Lahey Hospital and Medical Center, Burlington.
Tufts University School of Medicine, Boston, Massachusetts.
J Infect Dis. 2017 Sep 15;216(suppl_5):S588-S593. doi: 10.1093/infdis/jix326.
While a career in infectious diseases (ID) has always been challenging and exciting, recognition of the value that ID physicians provide to the healthcare system as a whole, over and above the value they provide to individual patients, has been poor in this system. In response to this disparity, the Infectious Diseases Society of America Clinical Affairs Committee has long endeavored to quantify the value of ID physicians to the system, which is challenging in part because of the many avenues through which they influence healthcare. We discuss data showing that ID physicians improve clinical outcomes, positively impact transitions of care, and direct system-level improvements through infection prevention and antimicrobial stewardship. We identify areas where value-based care provides additional future opportunities for ID physicians. A Clinical Affairs Committee-sponsored study of ID physicians' positive impact on patient outcomes shows that few medical specialties are better positioned to positively impact the Triple Aim approach-better health, better care, and lower per capita cost-that is the principle tenet of healthcare system reform.
虽然传染病(ID)领域的职业一直充满挑战且令人兴奋,但在整个医疗体系中,传染病医生为整个医疗体系带来的价值,超出了他们为个体患者提供的价值,这一点在该体系中并未得到充分认可。针对这种差距,美国传染病学会临床事务委员会长期致力于量化传染病医生对该体系的价值,这一工作颇具挑战性,部分原因在于他们影响医疗保健的途径众多。我们讨论的数据表明,传染病医生能改善临床结果,对医疗护理的过渡产生积极影响,并通过感染预防和抗菌药物管理推动系统层面的改进。我们确定了基于价值的医疗为传染病医生提供更多未来机会的领域。临床事务委员会发起的一项关于传染病医生对患者结果的积极影响的研究表明,很少有医学专业能像传染病医生这样,更有能力对“三重目标”方法——改善健康、提供更好的护理以及降低人均成本,这一医疗体系改革的主要原则——产生积极影响。