Delineating episodes of medical care.
Delineating episodes of medical care.
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描述医疗护理的情节。
DOI：
10.2105/ajph.57.3.401
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发表时间：
1967
期刊：
影响因子：
--
通讯作者：
C. Sheps
中科院分区：
文献类型：
--
作者：
J. Solon;J. Feeney;S. H. Jones;R. D. Rigg;C. Sheps
报告TOF医疗服务使用情况的各种数据通常远远不能反映复杂的医疗保健现实。需要更具启发性的利用指标，以反映个人和民众接受医疗服务的实际过程和内容。用来描述人口所获得的医疗服务的汇总统计数据通常采用以下形式：(1)说明人口中有多少人在给定的时间段内获得了医疗服务(用户数量)，和/或(2)以就诊次数、住院天数、X光检查、实验室测试、药物治疗、理疗治疗等形式表示服务的数量。这些累积是有价值的，因为它们以一种全面的方式代表了绝对的服务量。但它们的简单性、客观性和表面上的精确度在欺骗性上令人放心。它们制造了这样一种错觉，即利用的基本事实就是这样表达出来的。除了这些表面的统计数字，还有更多关于医疗保健的信息。能够说出这一点很重要。随着医疗本身变得更加复杂，设计有效反映利用情况的措施和方法的必要性也越来越大。然而，我们关于使用率的数据仍然以访问次数和天数等基本术语表示。无论这些传统的服务量衡量方法多么精确，从本质上讲，它们都不能充分反映医疗服务范围和特征的变化。仅对一系列服务单位进行统计的传统措施的不足之处在于，它们没有针对问题的核心，而不是代表医疗保健的“自然历史”。一位敏锐的观察者恰如其分地说：“……科学的光荣在于它的测量越来越精确，而科学家却痛苦地发现，当他的测量真正精确时，他所测量的只是他所追求的东西的一面。”
T HE kinds of data which report the use Tof medical services generally fall far short of representing the complex reality of medical care. More revealing measures of utilization are needed to reflect the actual course and content of the medical care received by individuals and populations.' The summary statistical data used to describe the medical care received by a population usually take the form of (1) stating how many in the population have obtained medical services in a given period of time (the volume of users), and/or (2) expressing the volume of services in terms of the number of physician visits made, the days of inpatient care provided, the number of x-rays, lab tests, medications, physical therapy treatments, and so on. These cumulations are valuable in so far as they represent, in an over-all way, the sheer volume of service. But their very simplicity, their objectivity, and apparent precision are deceptively reassuring. They create the illusion that the essential facts of utilization are thus expressed. There is much more to tell of medical care than these superficial counts reveal. And it is important to be able to tell it. The need to design measures and methods to reflect utilization effectively is intensified as medical care itself grows more complex. Yet our data on utilization remain couched in such elementary terms as counts of visits and days. No matter how precise these traditional measures of service volume, they are by their nature incapable of adequately representing the changing scope and character of medical care. The deficiency of the conventional measures in merely tallying a procession of units of service is that they are not addressed to the heart of the matterto represent the "natural history" of medical care. A keen observer has aptly stated that ". . . it is the glory of science to become ever more and more precise in its measurements, and it is the agony of the scientist to discover that when his measurements are really precise, what he has measured is just to one side of what he is after."2