Natiello T A
Institute for Health Administration and Research, School of Business Administration, University of Miami, Coral Gables, FL.
Am J Hosp Pharm. 1988 Mar;45(3):540-2.
New perspectives on the economic aspects of clinical decision making in the changing health-care environment are discussed. Economic appraisal of health-care delivery offers a mechanism for categorizing choices, assigning priorities, and consolidating disparate aspects of a problem into common measures, such as the ratio of cost to a desired outcome. While past applications of this technique to health care usually considered only one aspect of patient care at a time, the importance of examining the entire process of patient-care activities and the outcome of that process is now recognized. Clinical decision making should transcend traditional boundaries, such as departments, specialty activities, and institutions. The methods of optimizing health-care outcome must be incorporated into the organization's mission, goals, and reward system. Economic evaluations of clinical decision making should incorporate a framework in which choices are related to desired outcomes and beneficial situations. The challenges lie in defining overall measures of health-care provision and developing management information systems reflecting these patient-care objectives and desired outcomes.
本文讨论了在不断变化的医疗环境中临床决策经济方面的新观点。医疗服务的经济评估提供了一种机制，用于对选择进行分类、确定优先事项，并将问题的不同方面整合为通用指标，如成本与预期结果的比率。虽然过去将该技术应用于医疗保健时通常一次只考虑患者护理的一个方面，但现在人们认识到检查患者护理活动的整个过程及其结果的重要性。临床决策应超越传统界限，如部门、专科活动和机构。优化医疗保健结果的方法必须纳入组织的使命、目标和奖励系统。临床决策的经济评估应纳入一个框架，在该框架中，选择与预期结果和有益情况相关。挑战在于定义医疗保健提供的总体指标，以及开发反映这些患者护理目标和预期结果的管理信息系统。
