Gillen Glen, Hunter Elizabeth G, Lieberman Deborah, Stutzbach Melissa
Glen Gillen, EdD, OTR, FAOTA, is Vice Chair and Director of Programs in Occupational Therapy, Department of Rehabilitation and Regenerative Medicine, Columbia University Irving Medical Center, New York; Assistant Dean, Vagelos College of Physicians and Surgeons, Columbia University, New York; and Project Champion, Choosing Wisely® initiative, AOTA, Bethesda, MD.
Elizabeth G. Hunter, PhD, OTR/L, is Assistant Professor, The Graduate Center for Gerontology, University of Kentucky, Lexington, and Research Methodologist, Evidence-Based Practice Project, AOTA, Bethesda, MD.
Am J Occup Ther. 2019 Mar/Apr;73(2):7302420010p1-7302420010p9. doi: 10.5014/ajot.2019.732001.
Health care spending in the United States continues to grow at an unsustainable rate. In 2015, spending increased 5.8%, to reach $3.2 trillion, or $9,990 per person. As a share of the nation's gross domestic product, health spending accounted for 17.8% (Morgan et al., 2016). A critical component of addressing this issue is eliminating wasteful spending without reducing quality and appropriate care. In 2012, Choosing Wisely, an initiative of the ABIM Foundation (American Board of Internal Medicine), started with the aim to encourage meaningful conversations between health care practitioners and clients to ensure that appropriate and quality care is being provided. The American Occupational Therapy Association (AOTA) made a commitment to join Choosing Wisely in 2016. With support and input from AOTA members, the Board of Directors, and staff, AOTA implemented a three-phase process to develop and publish the list, "Five Things Patients and Providers Should Question." The goal of AOTA's participation in this initiative is to start dialogue within the occupational therapy profession about providing quality services that are supported by evidence, not duplicative, free from harm, and truly necessary.
美国医疗保健支出持续以不可持续的速度增长。2015年，支出增长了5.8%，达到3.2万亿美元，即人均9990美元。作为国家国内生产总值的一部分，医疗支出占17.8%（摩根等人，2016年）。解决这一问题的一个关键要素是消除浪费性支出，同时不降低医疗质量和适当的医疗服务。2012年，美国内科医学委员会基金会（ABIM基金会）发起的“明智选择”倡议开始实施，旨在鼓励医疗从业者与患者进行有意义的对话，以确保提供适当且高质量的医疗服务。美国职业治疗协会（AOTA）于2016年承诺加入“明智选择”倡议。在美国职业治疗协会成员、董事会和工作人员的支持与投入下，美国职业治疗协会实施了一个三阶段流程，以制定并公布“患者和医疗服务提供者应质疑的五件事”清单。美国职业治疗协会参与该倡议的目标是在职业治疗行业内开启对话，讨论如何提供有证据支持、不重复、无危害且真正必要的高质量服务。
