Bosch J P, Luckenbill L
Renal Hypertension Division, George Washington University Medical Center, Washington, DC 20037, USA.
Adv Ren Replace Ther. 1997 Oct;4(4):325-31. doi: 10.1016/s1073-4449(97)70021-9.
Nephrology represents a powerful example of the impact of new medical technology; almost 200,000 patients are alive in the United States because of renal replacement therapy. However, ESRD patient morbidity and life expectancy are still serious concerns despite advances in medical treatment. A capitated payment system for end-stage renal disease (ESRD) could be a great benefit to the renal community as it would force us to rethink the way ESRD care is provided. By applying the concepts of integration of services, disease management, and case management to ESRD care under a capitated payment system, providers may be able to improve patient outcomes and overall well-being.
肾脏病学是新医疗技术产生影响的一个有力例证；在美国，近20万名患者因肾脏替代疗法得以存活。然而，尽管医疗有所进步，终末期肾病（ESRD）患者的发病率和预期寿命仍是严重问题。针对终末期肾病的按人头付费系统可能会给肾脏医疗领域带来巨大益处，因为这将迫使我们重新思考终末期肾病护理的提供方式。通过在按人头付费系统下将服务整合、疾病管理和病例管理的概念应用于终末期肾病护理，医疗服务提供者或许能够改善患者的治疗效果和整体健康状况。
