More variation in use of care, more flat-of-the-curve medicine
More variation in use of care, more flat-of-the-curve medicine
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DOI：
10.1377/hlthaff.var.104
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发表时间：
2004-11-01
期刊：
影响因子：
9.7
通讯作者：
Fuchs, VR
中科院分区：
文献类型：
--
作者：
Fuchs, VR
在美国，医疗保健使用的差异是普遍存在的。这是医疗资源供给的外生差异造成的”。已识别和未识别的经济、社会和文化因素；以及医生独特的信念。许多临床实践的狭隘性使这种现象得以延续。高强度地区的患者似乎没有更好的健康结果：许多护理是“曲线平坦的”。临床决策的更强大的科学基础可能有助于减少变化，但医疗保健融资的重大改革可能是实现医疗组织和提供方面的实质性改进所必需的。
Variation in use of health care is ubiquitous in the United States. It is attributable to exogenous differences in supply of medical resources'. to identified and unidentified economic, social, and cultural factors; and to the idiosyncratic beliefs of physicians. It is perpetuated by the parochial character of much clinical practice. Patients in high-intensity areas do not appear to have better health outcomes: Much care is "flat of the curve." A more robust scientific foundation for clinical decisions could help to reduce variations, but major reform of health care financing is probably necessary to achieve substantial improvement in the organization and delivery of care.