Lybrand Kyle E, Althausen Peter L
Reno Orthopaedic Clinic, 555. North Arlington Avenue, Reno, NV 89503, USA.
Reno Orthopaedic Clinic, 555. North Arlington Avenue, Reno, NV 89503, USA.
Orthop Clin North Am. 2018 Oct;49(4):437-443. doi: 10.1016/j.ocl.2018.05.005. Epub 2018 Jun 27.
Health care costs in the United States continue to rise, and economic pressures influencing the care of the orthopedic trauma patient have never been greater. Value-based health care is vital to the survival of the current health care system, and the use of value-based implants is central to success. Value-based implants have similar clinical outcomes to conventional implants; however, multiple barriers exist. Despite biomechanical equivalence and significant cost savings, surgeons have difficultly changing implant use without financial incentive. The rise of physician-owned surgery centers, bundled payments, and gain sharing and comanagement agreements will likely drive this change.
美国的医疗保健成本持续上升,影响骨科创伤患者护理的经济压力前所未有的大。基于价值的医疗保健对于当前医疗保健系统的生存至关重要,而使用基于价值的植入物是成功的关键。基于价值的植入物与传统植入物具有相似的临床结果;然而,存在多重障碍。尽管在生物力学上等效且能显著节省成本,但如果没有经济激励,外科医生很难改变植入物的使用。医生拥有的手术中心的兴起、捆绑支付、收益共享和共同管理协议可能会推动这一变化。