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心脏病学中的价值医疗:如何将更全面的观点纳入医疗决策?

Value-Based Healthcare in Cardiology: How to Integrate a more Comprehensive View into Medical Decision-Making?

作者信息

Silva Pedro Gabriel Melo de Barros E, Furlan Valter, Lopes Renato D, Volschan André, Souza Paulo Cesar Pereira de, Polanczyk Carisi Anne

机构信息

Brazilian Clinical Research Institute, São Paulo, SP - Brasil.

Hospital do Coração (HCOR), São Paulo, SP - Brasil.

出版信息

Arq Bras Cardiol. 2025 Apr 4;122(2):e20240668. doi: 10.36660/abc.20240668. eCollection 2025.

Abstract

Value-based healthcare is a patient-centered concept that provides a broad view of all parties involved in the care process. This model is designed to achieve the best possible patient outcomes while maintaining cost sustainability. In its classic description, value-based care is the relationship between outcomes that matter to the patient and the costs required to achieve them. Later, other variables were considered in this equation, such as appropriateness and user experience, to make this model more replicable. With a view that aligns the interests of patients, physicians, and payers, value-based healthcare has great potential to improve medical practice sustainably. After more than a decade of discussions and publications, putting this concept into practice is still challenging and dynamic. Value-based healthcare has gained importance and should become a transformative model for health ecosystems. Medical compensation aligned with these principles appears to be a promising path toward such transformation. Nevertheless, the application of this concept depends on a more straightforward definition of the health value parameters in different clinical scenarios. Cardiology is a specialty that usually has a solid evidence base for medical decision-making and this generates great potential for the application of health value elements. In this article, the authors outline a review of the main concepts of value-based healthcare and its potential applications in cardiology.

摘要

基于价值的医疗保健是一种以患者为中心的理念,它全面涵盖了医疗过程中涉及的所有各方。该模式旨在实现尽可能最佳的患者治疗效果,同时保持成本的可持续性。在其经典描述中,基于价值的医疗保健是患者所重视的治疗效果与实现这些效果所需成本之间的关系。后来,此等式中还考虑了其他变量,如医疗服务的适宜性和用户体验,以使该模式更具可复制性。基于价值的医疗保健兼顾了患者、医生和支付方的利益,具有可持续改善医疗实践的巨大潜力。经过十多年的讨论和发表,将这一概念付诸实践仍然具有挑战性且不断变化。基于价值的医疗保健已变得愈发重要,应成为健康生态系统的变革性模式。与这些原则相一致的医疗补偿似乎是实现这种转变的一条充满希望的途径。然而,这一概念的应用取决于对不同临床场景中健康价值参数更明确的定义。心脏病学是一个通常在医疗决策方面有坚实证据基础的专业领域,这为健康价值元素的应用创造了巨大潜力。在本文中,作者概述了对基于价值的医疗保健的主要概念及其在心脏病学中的潜在应用的综述。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ec6b/12058157/0fbefa0e40b9/0066-782X-abc-122-2-e20240668-gf01.jpg

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