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商品医疗的兴起。

The rise of commodity care.

作者信息

Neczypor Jacy E

机构信息

London School of Hygiene and Tropical Medicine, London, United Kingdom.

Department of Health Policy, London School of Economics and Political Science, London, United Kingdom.

出版信息

Front Health Serv. 2025 Jul 7;5:1611746. doi: 10.3389/frhs.2025.1611746. eCollection 2025.

Abstract

The commoditization of health care under the guise of advanced preventive services and data-driven performance optimization poses risks for patient care and lessons for health systems. This editorial defines and examines "commodity care," a growing model of direct-to-consumer healthcare characterized by self-referral for advanced diagnostic imaging and/or serologic testing. Promoted as empowering and proactive preventive care, commodity care services frequently operate beyond established clinical guidelines and lack robust evidence to support their clinical utility. Despite appealing marketing claims, these services carry significant risks for patients, including overdiagnosis, false-positive results, and incidental findings that lead to unnecessary interventions that may cause physical, psychological, and financial harms. At the health system level, commodity care contributes to fragmented patient experiences, promotes low-value utilization of healthcare resources, and raises ethical and environmental concerns related to data stewardship and sustainability. Yet, the rising demand for these services also suggests a deeper dissatisfaction among patients with traditional care models, particularly around issues of access, responsiveness, and personalization. Whether driven primarily by shortcomings of conventional healthcare delivery or by shifting patient expectations, the expansion of commodity care warrants careful attention from clinicians, policymakers, and regulators. Defining commodity care is an imperative first step in understanding its implications. This editorial advocates for increased regulatory oversight and rigorous evaluation of emerging healthcare models that increasingly blur distinctions between clinical medicine and consumer-oriented services. Ultimately, the advancement of healthcare technology should support-not erode-the quality, value, and patient-centeredness of care.

摘要

在先进预防服务和数据驱动的绩效优化的幌子下,医疗保健的商品化给患者护理带来了风险,并为卫生系统提供了教训。这篇社论定义并审视了“商品护理”,这是一种日益增长的直接面向消费者的医疗保健模式,其特点是自我推荐进行先进的诊断成像和/或血清学检测。作为赋权和积极主动的预防保健而被推广的商品护理服务,常常超出既定的临床指南运作,并且缺乏有力证据来支持其临床效用。尽管有吸引人的营销宣传,但这些服务给患者带来了重大风险,包括过度诊断、假阳性结果以及偶然发现导致不必要的干预,而这些干预可能造成身体、心理和经济伤害。在卫生系统层面,商品护理导致患者体验碎片化,促进了医疗资源的低价值利用,并引发了与数据管理和可持续性相关的伦理和环境问题。然而,对这些服务需求的不断上升也表明患者对传统护理模式存在更深层次的不满,特别是在可及性、响应性和个性化问题方面。无论是主要由传统医疗服务的缺陷还是患者期望的转变所驱动,商品护理的扩张都值得临床医生、政策制定者和监管者予以密切关注。定义商品护理是理解其影响的必要第一步。这篇社论主张加强监管监督,并对新兴的医疗保健模式进行严格评估,这些模式日益模糊了临床医学与面向消费者的服务之间的区别。最终,医疗技术的进步应该支持——而不是侵蚀——护理的质量、价值和以患者为中心的理念。

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