Hales J W, Gardner R M, Jacobson J T
Division of Medical Informatics, Duke University Medical Center, Durham, NC, USA.
Proc Annu Symp Comput Appl Med Care. 1995:728-32.
Many approaches to controlling costs under managed care rely on the ability to prospectively identify the type or level of service a patient requires at the time of presentation. Although computers may effectively predict these factors, the impact of such a computer system is greatly dependent on its integration into the admission process. Three factors that influence the effectiveness of predictive screening using a computer were identified. They are detection, intervention and compliance. The effect of these factors was then measured in a prospective randomized trial evaluating the effectiveness of computerized preadmission screening for predicting the appropriateness of inpatient care. This paper examines the three factors and their impact on the effectiveness of the system. A mathematical model that relates the factors to the overall effectiveness of computerized preadmission screening is proposed and considered in a more general context.
管理式医疗下的许多成本控制方法都依赖于在患者就诊时前瞻性地确定其所需服务的类型或水平的能力。尽管计算机可以有效地预测这些因素，但这种计算机系统的影响在很大程度上取决于其与入院流程的整合。确定了影响使用计算机进行预测性筛查有效性的三个因素。它们是检测、干预和依从性。然后，在一项前瞻性随机试验中测量了这些因素的效果，该试验评估了计算机化入院前筛查对预测住院护理适宜性的有效性。本文研究了这三个因素及其对系统有效性的影响。提出了一个将这些因素与计算机化入院前筛查的整体有效性相关联的数学模型，并在更广泛的背景下进行了考量。
