Eve A. Kerr (
Jeffrey T. Kullgren is an investigator in the Center for Clinical Management Research at VA Ann Arbor and an assistant professor in the Department of Internal Medicine, the Institute for Healthcare Policy and Innovation, and the Center for Bioethics and Social Sciences in Medicine, University of Michigan.
Health Aff (Millwood). 2017 Nov;36(11):2012-2018. doi: 10.1377/hlthaff.2017.0953. Epub 2017 Oct 24.
Low-value care-the use of unnecessary and potentially harmful health care services-accounted for roughly $200 billion in wasteful spending in the United States in 2011. In 2012 the ABIM Foundation and Consumer Reports launched the Choosing Wisely® campaign, inspired by the idea that professional societies and health care providers should take the lead in defining and motivating efforts to reduce the use of low-value care. But decreases in that use have been slow in coming. We discuss the campaign's significant accomplishments in the past five years and summarize the work that is needed to fulfill the promise of Choosing Wisely. We focus on innovations in three main areas: identifying high-priority clinical targets, developing theory-based interventions, and evaluating interventions in ways that are clinically meaningful.
低价值医疗保健——使用不必要且可能有害的医疗保健服务——占 2011 年美国浪费性支出的约 2000 亿美元。2012 年,ABIM 基金会和消费者报告发起了明智选择(Choosing Wisely)运动,其灵感来自这样一个理念,即专业协会和医疗保健提供者应该带头定义和激励减少低价值医疗保健的使用。但这种使用的减少速度缓慢。我们讨论了该运动在过去五年中的重大成就,并总结了实现明智选择承诺所需的工作。我们专注于三个主要领域的创新:确定高优先级的临床目标、开发基于理论的干预措施以及以具有临床意义的方式评估干预措施。