Bandurska Ewa, Ciećko Weronika, Olszewska-Karaban Marzena, Damps-Konstańska Iwona, Szalewska Dominika, Janowiak Piotr, Jassem Ewa
Center for Competence Development, Integrated Care and e-Health, Medical University of Gdańsk, 80-210 Gdańsk, Poland.
Division of Rehabilitation Medicine, Medical University of Gdańsk, 80-210 Gdańsk, Poland.
Healthcare (Basel). 2023 Apr 12;11(8):1110. doi: 10.3390/healthcare11081110.
Healthcare effectiveness measurement and value in health have been common topics in public health literature since 2006 when value-based healthcare (VBHC) was first defined by Porter and Teisberg. The aim of this study was to identify the barriers and challenges related to the implementation of VBHC solutions in the example of Poland. A case presentation was used as a method. The national integrated care programs (KOS-Infarction, POZ-Plus, and comprehensive treatment of chronic wounds) were used to present general challenges, along with the Integrated Care Model (ICM) for patients with advanced chronic obstructive pulmonary disease (COPD), to determine specific difficulties. ICM has been operating since 2012 in Gdańsk and gradually adapted the value-based integrated care (VBIC) approach. An analysis of the available data showed that the greatest difficulties related to the implementation of the VBHC and VBIC concepts are a lack of legal and reimbursement solutions, staff shortages, a lack of educational standards for some members of the multidisciplinary team, and insufficient awareness of the role of integrated care. As the level of preparation to implement VBHC policies varies between individual countries, the conclusions drawn from the experience of ICM and other Polish projects may be a valuable voice in discussion.
自2006年波特和泰斯伯格首次定义基于价值的医疗保健（VBHC）以来，医疗保健有效性测量和健康价值一直是公共卫生文献中的常见话题。本研究的目的是以波兰为例，确定与实施VBHC解决方案相关的障碍和挑战。采用案例呈现的方法。国家综合护理项目（KOS-心肌梗死、POZ-Plus和慢性伤口综合治疗）被用来呈现一般挑战，同时采用针对晚期慢性阻塞性肺疾病（COPD）患者的综合护理模式（ICM）来确定具体困难。ICM自2012年起在格但斯克开展运作，并逐步采用基于价值的综合护理（VBIC）方法。对现有数据的分析表明，与实施VBHC和VBIC概念相关的最大困难包括缺乏法律和报销解决方案、人员短缺、多学科团队某些成员缺乏教育标准以及对综合护理作用的认识不足。由于各国实施VBHC政策的准备水平各不相同，从ICM和其他波兰项目的经验中得出的结论可能会在讨论中发出有价值的声音。
