Bains Manpreet, Warriner David, Behrendt Katja
GP, Imperial College Health Partners, London.
Cardiology Registrar, Department of Cardiology, Leeds Teaching Hospitals NHS Trust, Leeds.
Br J Hosp Med (Lond). 2018 Jun 2;79(6):312-315. doi: 10.12968/hmed.2018.79.6.312.
The Five Year Forward View ( NHS England, 2014 ) endorses outcomes-based approaches and integrated care systems. This article looks at the role and functions of hospitals in value-based health-care systems, following Porter's value-based health-care framework. Changes will be required not only in the way health care is organized within a hospital in the form of so-called integrated practice units, but more importantly primary and secondary care will have to work together to realize value for patients across the health-care pathway and system. It will be necessary to build an enabling IT platform that facilitates an integrated dataset across primary and secondary care to measure outcomes and costs across patient pathways. Finally, new payment models will be required to remove current barriers and allow clinicians to do the right things for their patients without organizations being penalized. The final section describes current maturity of the system, opportunities and challenges in the UK.
《五年展望》（英国国民医疗服务体系，2014年）认可基于结果的方法和综合医疗系统。本文依据波特的基于价值的医疗框架，探讨了医院在基于价值的医疗体系中的角色和功能。不仅医院内部医疗服务的组织方式需要以所谓的综合实践单位的形式进行变革，更重要的是，初级和二级医疗必须共同努力，以在整个医疗途径和系统中为患者实现价值。有必要构建一个支持性的信息技术平台，以促进跨初级和二级医疗的综合数据集，从而衡量患者就医途径中的结果和成本。最后，将需要新的支付模式来消除当前的障碍，并使临床医生能够为患者做正确的事情，而不会使医疗机构受到惩罚。最后一部分描述了该系统目前在英国的成熟度、机遇和挑战。
