Cohen Mitchell I, Frias Patricio A
Inova Children's Hospital, Inova Heart and Vascular Institute, Falls Church, Virginia.
Sibley Heart Center, Children's Healthcare of Atlanta, Emory University School of Medicine, Atlanta, Georgia, USA.
Curr Opin Cardiol. 2018 Jan;33(1):117-120. doi: 10.1097/HCO.0000000000000478.
The purpose of this review is to explore the paradigm shift in healthcare delivery that will need to take place over the next few years away from an emphasis on supply-driven health care to better quality transparent-driven health care whose focus is on the consumer's best interest.
The current healthcare system is fragmented and costs continue to rise. The best way to contain costs is to improve quality to the consumer, the patient. Physicians and hospitals need to align in a team-based approach that allows physicians to understand current costs and how to strive toward a focus on healthcare outcomes. Pediatric cardiology is a unique discipline that cares for patients with complex congenital conditions that will span their lifetime and also involves not just cardiology but surgery, intensive care, anesthesia, nursing, and a host of inpatient and ambulatory services. Understanding what matters to the patient and his/her family and presenting quality outcomes in a transparent fashion will gradually allow a shift to take place away from physician visits, tests ordered, and procedures performed. This can only be achieved with physicians, given the appropriate tools to understand costs, value, and outcomes and models where the hospitals and physicians are aligned.
The transformation to a value-based healthcare system is beginning and pediatric cardiologists need to be educated, given the appropriate resources, receive appropriate feedback, and patients need to be part of the solution so that care providers can understand what matters most to them.
本综述旨在探讨未来几年医疗服务提供模式的转变，即从强调供应驱动的医疗保健转向以消费者最大利益为重点的高质量透明驱动的医疗保健。
当前的医疗保健系统分散，成本持续上升。控制成本的最佳方法是提高对消费者（即患者）的医疗质量。医生和医院需要采用基于团队的方法进行协作，使医生了解当前成本以及如何努力关注医疗保健结果。儿科心脏病学是一门独特的学科，负责照顾患有复杂先天性疾病且将伴随一生的患者，不仅涉及心脏病学，还包括外科、重症监护、麻醉、护理以及一系列住院和门诊服务。了解对患者及其家人重要的事情，并以透明的方式呈现质量结果，将逐渐促使医疗模式从关注医生问诊、检查项目和实施的手术，转向以患者为中心。只有给予医生适当的工具来理解成本、价值和结果，并建立医院与医生协作的模式，才能实现这一转变。
向基于价值的医疗保健系统的转变已经开始，儿科心脏病专家需要接受教育，获得适当的资源，得到适当的反馈，并且患者需要成为解决方案的一部分，以便医疗服务提供者能够了解对他们最重要的事情。
