Variations in the longitudinal efficiency of academic medical centers
Variations in the longitudinal efficiency of academic medical centers
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DOI：
10.1377/hlthaff.var.19
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发表时间：
2004-11-01
期刊：
影响因子：
9.7
通讯作者：
Gottlleb, DJ
中科院分区：
文献类型：
--
作者：
Fisher, ES;Wennberg, DE;Gottlleb, DJ
最近的研究表明，学术医疗中心（AMC）在为患者提供的护理数量方面存在显着差异。然而，其影响取决于一些中心提供的额外资源是否会带来更好的结果。这项研究描述了AMC的内容，质量和护理结果，这些AMC在向严重慢性病患者提供的医疗服务的整体强度方面差异高达60%。降低成本的努力将需要注意对供应敏感的服务（住院、医生就诊、专家咨询、诊断测试和小程序的频率），并应包括注重医院和医务人员的纵向效率。
Recent studies have revealed dramatic differences among academic medical centers (AMCs) in the quantity of care provided to their patients. The implications, however, depend upon whether the additional resources provided by some centers lead to better results. This study describes the content, quality, and outcomes of care across AMCs that differ by up to 60 percent in the overall intensity of medical services delivered to patients with serious chronic illnesses. Efforts to reduce costs will require attention to supply-sensitive services (the frequency of hospital stays, physician visits, specialist consultations, diagnostic tests, and minor procedures) and should include a focus on the longitudinal efficiency of hospitals and medical staffs.