The RAND/UCLA Appropriateness Method User's Manual
The RAND/UCLA Appropriateness Method User's Manual
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发表时间：
2001
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通讯作者：
Kathryn Fitch;Steven J. Bernstein;Marfa D. Aguilar;Bernard Burnand;Juan R Lacalle
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作者：
Kathryn Fitch;Steven J. Bernstein;Marfa D. Aguilar;Bernard Burnand;Juan R Lacalle
摘要：适当和必要护理的概念是建立一个有效和公平的卫生保健提供系统的基础。即使在缺乏全球预算、经费、使用情况审查或要求第二意见的压力的卫生系统中，也有证据表明程序的不当过度使用和使用不足。卫生系统应以这样一种方式运作：逐步减少不适当的护理，同时保持或增加适当的、特别是必要的护理。确定和确定哪些护理被过度使用，哪些未被充分使用的能力对这一功能至关重要。为此，兰德和加州大学洛杉矶分校在20世纪80年代开发了“兰德/加州大学洛杉矶分校适当性方法”（这里给出了缩写RAM）。它在北美得到了进一步的发展和完善，在欧洲也得到了越来越多的发展。
Abstract : The concepts of appropriate and necessary care are fundamental to the creation of an efficient and equitable health-care delivery system. Evidence of inappropriate overuse and underuse of procedures has been documented even in health systems characterised by the absence of global budgets, capitation, utilisation review or the pressure of requiring a second opinion. Health systems should function in such a way that inappropriate care is progressively reduced, while appropriate and especially necessary care are maintained or increased. The ability to determine and identify which care is overused and which is underused is essential to this functioning. To this end, the "RAND/UCLA Appropriateness Method" (here given the acronym RAM) was developed by RAND and UCLA in the 198Os. It has been further developed and refined in North America and, increasingly, in Europe.