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追求以价值为基础的孕产妇保健。

In Pursuit of Value-Based Maternity Care.

机构信息

Department of Obstetrics & Gynecology, Beth Israel Deaconess Medical Center, Harvard Medical School, and Ariadne Labs at Brigham and Women's Hospital and the Harvard T.H. Chan School of Public Health, Boston, Massachusetts.

出版信息

Obstet Gynecol. 2019 Mar;133(3):541-551. doi: 10.1097/AOG.0000000000003113.

Abstract

Value-based care has become the new paradigm for clinical practice, with significant implications for maternity services, where there is a large opportunity to provide better care at lower cost. Childbirth is the most common reason for hospitalization in the United States and represents the single largest category of hospital-based expenditures. At the same time, the United States ranks low among developed countries on measures of maternal and neonatal health, suggesting that we are not using resources optimally. Improving the value of maternity services will require public policies that measure and pay for quality rather than quantity of care. Equally important, clinicians will need to employ new strategies to deliver value, including considering prices, individualizing the use of new technologies, prioritizing team-based approaches to care, bridging pregnancy and contraception counseling, and engaging expecting families in new ways.

摘要

基于价值的医疗保健已成为临床实践的新模式,这对妇产科服务产生了重大影响,因为这是提供更优质、低成本医疗服务的重要机会。分娩是美国最常见的住院原因,也是医院支出的最大类别。与此同时,美国在衡量母婴健康的指标上在发达国家中排名靠后,这表明我们没有优化资源的利用。提高妇产科服务的价值需要制定公共政策,衡量和支付医疗质量而非数量。同样重要的是,临床医生需要采用新的策略来创造价值,包括考虑价格、个性化使用新技术、优先采用团队合作的护理方法、将妊娠和避孕咨询相结合,并以新的方式让准家庭参与进来。

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