Quality of Care NL, Faculty of Medicine, Memorial University, St. John's, NL, Canada.
Methods Mol Biol. 2021;2249:553-569. doi: 10.1007/978-1-0716-1138-8_30.
The quantity of health spending does not equate directly to the quality of healthcare. Social spending and nonmedical determinants of health impact on health outcomes. The value of health spending in the United States is limited by the high cost of goods and labor, and administrative costs, high use of low-level care, and lack of basic healthcare coverage in a substantial minority of the population. There are additional reasons for differences in the value of health spending as revealed by a comparison of Canada and Australia, where similar spending per capita results in better health system performance in Australia than in Canada. Within Canada, there are large differences between provinces in the value of health spending. Overutilization of health resources occurs when an intervention is not indicated, or of low value, or is provided at the wrong time. The Choosing Wisely Initiative is a solution for overutilization of low-value care. Recognition of the reality that effective treatments are often applied inconsistently and inappropriately has spurred the development of a science concerned with improvement of quality of care.
卫生支出的数量并不直接等同于医疗保健的质量。社会支出和健康的非医疗决定因素影响健康结果。美国卫生支出的价值受到商品和劳动力成本高、行政成本高、低水平护理使用率高以及相当一部分人口缺乏基本医疗保健覆盖的限制。加拿大和澳大利亚的卫生支出价值存在差异，这表明存在其他原因，尽管人均支出相似，但澳大利亚的卫生系统绩效优于加拿大。在加拿大内部，各省之间的卫生支出价值存在很大差异。当干预措施没有指征、价值低或在错误的时间提供时，就会发生卫生资源的过度利用。明智选择倡议是解决低价值医疗过度使用的方法。人们认识到，有效的治疗方法往往应用不一致和不适当，这促使人们发展了一门关注改善护理质量的科学。
