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迈向基于价值观的遗传性代谢疾病医疗保健:肝糖贮积症和脂肪酸氧化障碍患者现行实践概述。

Towards values-based healthcare for inherited metabolic disorders: An overview of current practices for persons with liver glycogen storage disease and fatty acid oxidation disorders.

机构信息

Department of Metabolic Diseases, Beatrix Children's Hospital, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands.

Department of Translational Medicine, Section of Pediatrics, University of Naples "Federico II", Naples, Italy.

出版信息

J Inherit Metab Dis. 2022 Nov;45(6):1018-1027. doi: 10.1002/jimd.12555. Epub 2022 Sep 30.

Abstract

Value-based healthcare (VBHC) intends to achieve better outcomes for patients, to improve quality of patient care, with reduced costs. Four dimensions define a model of intimately related value-pillars: personal value, allocative value, technical value, and societal value. VBHC is mostly applied in common diseases, and there are fundamental challenges in applying VBHC strategies to low volume, high complex healthcare situations, such as rare diseases, including inherited metabolic disorders. This article summarizes current practices at various academical domains (i.e., research, healthcare, education, and training) that (aim to) increase values at various value-pillars for persons with liver glycogen storage diseases or fatty acid oxidation disorders and their families. Future perspectives may include facilitating virtual networks to function as integrated practice units, improving measurement of outcomes, and creating information technology platforms to overcome the ethical, legal, societal, and technical challenges of data sharing for healthcare and research purposes.

摘要

基于价值的医疗保健(VBHC)旨在为患者实现更好的治疗效果,提高患者护理质量,同时降低成本。有四个维度定义了一个紧密相关的价值支柱模型:个人价值、配置价值、技术价值和社会价值。VBHC 主要应用于常见疾病,而在低流量、高复杂的医疗保健情况下,如罕见病,包括遗传性代谢紊乱,应用 VBHC 策略存在根本性挑战。本文总结了各个学术领域(即研究、医疗保健、教育和培训)的当前实践,这些实践旨在为患有肝糖原贮积病或脂肪酸氧化紊乱的患者及其家属提高各个价值支柱的价值。未来的展望可能包括促进虚拟网络作为综合实践单位发挥作用,改善结果的衡量标准,并创建信息技术平台,以克服医疗保健和研究目的的数据共享的伦理、法律、社会和技术挑战。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b791/9828459/7ceddf7d7268/JIMD-45-1018-g002.jpg

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