Wood R W, Tompkins R K, Wolcott B W
Ann Intern Med. 1980 Nov;93(5):757-63. doi: 10.7326/0003-4819-93-5-757.
A safe, effective, and efficient clinical algorithm (management rule) for the care of adults with acute respiratory illness by nonphysician providers is presented. The algorithm was created from a data base collected on more than 5000 patients and prospectively evaluated on an additional 2637. It eliminates unhelpful diagnostic tests and minimizes physician involvement in patient care without compromising clinical standards, illness outcome, or patient satisfaction. Total direct medical care costs when the algorithm was used were approximately 40% of those costs generated by physicians managing similar patients, primarily because the algorithm directed an 80% reduction in a diagnostic test costs. The results suggest that significant savings can result when algorithms are used in the care of ambulatory patients with common illnesses.
本文介绍了一种由非医生医疗人员用于护理成年急性呼吸道疾病患者的安全、有效且高效的临床算法（管理规则）。该算法基于收集的超过5000名患者的数据库创建，并在前瞻性研究中对另外2637名患者进行了评估。它排除了无用的诊断测试，并在不影响临床标准、疾病转归或患者满意度的情况下，最大限度地减少了医生对患者护理的参与。使用该算法时的直接医疗总费用约为医生管理类似患者产生费用的40%，主要原因是该算法使诊断测试费用降低了80%。结果表明，在护理患有常见疾病的门诊患者时使用算法可节省大量费用。
