Tai Waimei A, Conley Jared, Kalanithi Lucy
Clinical Excellence Research Center (WAT, JC, LK) and Stanford Stroke Center, Department of Neurology and Neurological Sciences (WAT), Stanford University, Palo Alto, CA.
Neurol Clin Pract. 2014 Oct;4(5):427-434. doi: 10.1212/CPJ.0000000000000081.
Health care costs continue to rise toward unsustainable levels that will affect our nation's ability to support other key funding priorities for education, military, and infrastructure. Changing the way we deliver health care is critical to mitigating this financial crisis. This review highlights opportunities for redesigning care of acute ischemic stroke and TIA to maintain quality while substantially lowering costs. The recent innovations described are (1) adopting teleneurology networks to improve access to thrombolysis for acute ischemic stroke; (2) improving efficiency of emergency care for acute ischemic stroke; and (3) providing alternatives to inpatient care for TIA. Applying such process innovations will enable us to achieve the goal of patients and the nation-high-quality care at an affordable cost.
医疗保健成本持续攀升，逼近难以为继的水平，这将影响我国为教育、军事和基础设施等其他关键资金优先事项提供支持的能力。改变我们提供医疗保健的方式对于缓解这场金融危机至关重要。本综述强调了重新设计急性缺血性中风和短暂性脑缺血发作（TIA）护理的机会，以在大幅降低成本的同时维持质量。所描述的近期创新包括：（1）采用远程神经病学网络，以改善急性缺血性中风患者获得溶栓治疗的机会；（2）提高急性缺血性中风急诊护理的效率；（3）为TIA提供住院护理的替代方案。应用这些流程创新将使我们能够实现患者和国家的目标，即以可承受的成本提供高质量护理。
