Clare M, Sargent D, Moxley R, Forthman T
HCIA Inc., Carpinteria, California, USA.
J Health Care Finance. 1995 Spring;21(3):48-58.
The process of merging and benchmarking clinical and financial data is pivotal to the development of appropriate clinical pathways. Bristol Regional Medical Center (BRMC), facing the challenge of managed care organizations (MCOs), instituted this process and achieved significant cost savings, largely because of the working partnership between the administration and its medical staff. In DRG 89, Simple Pneumonia and Pleurisy, Age Greater than 17 with CC, data adjusted for severity of illness and cost of living were furnished to BRMC by HCIA Inc. Major benchmark or "best practice" variations were incorporated into new clinical pathways, leading to decreased resource use, no compromise in the quality of care, and a beneficial halo effect on other unrelated DRGs.
合并临床数据与财务数据并进行基准对比的过程，对于制定恰当的临床路径至关重要。面对管理式医疗组织（MCOs）的挑战，布里斯托尔地区医疗中心（BRMC）开展了这一过程，并实现了显著的成本节约，这很大程度上得益于管理层与其医务人员之间的合作关系。在疾病诊断相关分组（DRG）89“单纯性肺炎和胸膜炎，年龄大于17岁且伴有并发症（CC）”中，HCIA公司向BRMC提供了根据疾病严重程度和生活成本调整后的数据。主要的基准对比或“最佳实践”差异被纳入新的临床路径，从而减少了资源使用，在不影响医疗质量的情况下，还对其他不相关的DRG产生了有益的光环效应。
