Bull Hosp Jt Dis (2013). 2022 Mar;80(1):102-106.
The advent of value-based care as a component of the United States health care system is part of a broader paradigm shifting away from fee-for-service payment models in favor of alternative reimbursement incentives tied to quality and outcome metrics. Bundled care models, gainsharing agreements, and other cost containment measures, although promising, may induce unintended systemwide consequences for orthopedic trauma surgeons who often specialize in tending to costly multiply injured patients and marginalized populations. This article reviews facets of value-based care applicable to orthopedic trauma surgery with an emphasis on public health and ethical considerations for policymakers and orthopedic surgeons.
基于价值的医疗保健作为美国医疗保健系统的一个组成部分的出现,是从按服务收费的支付模式向有利于与质量和结果指标挂钩的替代报销激励模式转变的更广泛范例的一部分。捆绑式护理模式、收益分享协议和其他成本控制措施虽然有前景,但可能会对专门治疗昂贵的多发性创伤患者和边缘化人群的骨科创伤外科医生产生意想不到的全系统后果。本文回顾了适用于骨科创伤外科的基于价值的医疗保健的各个方面,重点是政策制定者和骨科外科医生的公共卫生和伦理考虑因素。