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实践改变的代价:评估将研究结果整合到临床实践中的成本。

The Price of Practice Change: Assessing the Cost of Integrating Research Findings Into Clinical Practice.

机构信息

Patient-Centered Outcomes Research Institute, Washington, DC.

出版信息

Med Care. 2023 Oct 1;61(10):675-680. doi: 10.1097/MLR.0000000000001873. Epub 2023 Sep 7.

Abstract

BACKGROUND

Clinicians, health care administrators, and implementation scientists know that it takes intentional effort, resources, and implementation strategies to integrate research findings into routine clinical practice. An oft-cited concern for those considering whether and how to implement an evidence-based program is how much it will cost to implement the change. Yet information about the cost of implementation is not often available to health care decision-makers. Teams that received Implementation Award funding from PCORI are conducting implementation projects to promote the uptake of evidence-based practices in health care settings. As part of their implementation efforts, a number of teams have examined the costs of implementation. In this Topical Collection, 5 teams will report their findings on implementation costs and discuss their methods for data collection and analysis.

DISCUSSION

The teams' costing efforts provide specific information about the costs sites can expect to incur in promoting the uptake of specific evidence-based programs. In addition, the papers illuminate 3 key features of the teams' approaches to measuring the cost of implementation: (1) the use of specific micro-costing methods with time-driven activity-based costing serving as the most popular method; (2) different ways to categorize and organize costs, including a site-based and non-site-based framework; and (3) cost collection challenges experienced by the teams.

CONCLUSION

The cost of implementation is a critical consideration for organizations seeking to improve practice in accordance with research findings. This Topical Collection describes detailed approaches to providing this type of cost information and highlights insights to be gained from a rigorous focus on implementation cost.

摘要

背景

临床医生、医疗保健管理人员和实施科学家都知道,将研究结果融入常规临床实践需要有目的的努力、资源和实施策略。对于那些考虑是否以及如何实施基于证据的计划的人来说,一个经常被提到的问题是实施变革需要花费多少成本。然而,医疗保健决策者往往无法获得有关实施成本的信息。接受 PCORI 实施奖资助的团队正在开展实施项目,以促进在医疗保健环境中采用基于证据的实践。作为其实施工作的一部分,许多团队已经检查了实施成本。在本专题集中,5 个团队将报告他们关于实施成本的发现,并讨论他们的数据收集和分析方法。

讨论

这些团队的成本核算工作提供了有关网站在推广特定基于证据的项目时预计会产生的成本的具体信息。此外,这些论文阐明了团队衡量实施成本方法的 3 个关键特征:(1)使用特定的微观成本核算方法,时间驱动的活动成本核算最为流行;(2)对成本进行分类和组织的不同方法,包括基于站点和非基于站点的框架;(3)团队遇到的成本收集挑战。

结论

实施成本是组织根据研究结果改进实践的关键考虑因素。本专题集描述了提供此类成本信息的详细方法,并强调了从严格关注实施成本中获得的见解。

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