Tatman Lauren MacCormick, Obremskey William T
Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, MN.
Department of Orthopaedic Surgery, Vanderbilt University, Nashville, TN.
J Orthop Trauma. 2019 Nov;33 Suppl 7:S53-S55. doi: 10.1097/BOT.0000000000001613.
As we transition from volume-based to value-based health care, orthopedic surgeons must understand the role of outcomes in measuring value. Patient-reported outcomes (PROs) offer a number of advantages in orthopedic trauma compared with traditional clinical and radiographic results while also being an important indicator of the patient's perception of their condition. Patient-Reported Outcomes Measurement Information System, developed and funded by the National Institutes of Health, has a number of features that make PRO date collection less burdensome for providers and patients. Patient-specific factors, including comorbidities, mental health, social support, and preinjury function need to be accounted for in our assessment, because all of these factors have demonstrated an impact on outcomes. Orthopedic surgeons should be aware of how they can transition their practice in an era of value-based health care in a manner that will benefit their patients and provide insight into their own clinical practice. Prospective collection of PROs is no longer limited to academic surgeons conducting research, and all orthopedic surgeons should consider incorporating PROs into their daily clinical practice. Orthopedic surgeons must maintain an active role in the development of policies and reimbursement models to advocate for and serve our patients.
随着我们从基于数量的医疗保健向基于价值的医疗保健过渡,骨科医生必须了解结果在衡量价值方面的作用。与传统的临床和影像学结果相比,患者报告结果(PROs)在骨科创伤方面具有诸多优势,同时也是患者对自身病情认知的重要指标。由美国国立卫生研究院开发并资助的患者报告结果测量信息系统具有诸多特性,使得PRO数据收集对医疗服务提供者和患者而言负担减轻。在我们的评估中,需要考虑患者特定因素,包括合并症、心理健康、社会支持和伤前功能,因为所有这些因素都已证明对结果有影响。骨科医生应意识到,在基于价值的医疗保健时代,他们如何以有利于患者的方式转变自己的业务,并深入了解自己的临床实践。PROs的前瞻性收集不再局限于进行研究的学术外科医生,所有骨科医生都应考虑将PROs纳入日常临床实践。骨科医生必须在政策制定和报销模式的发展中发挥积极作用,以倡导并服务于我们的患者。