BEST: BEST ETHICAL STRATEGIES IN MANAGED CARE

最佳：管理医疗中的最佳道德策略

• 批准号: 6435361
• 负责人: ezekiel J emanuel
• 金额: --
• 依托单位: CLINICAL CENTER
• 依托单位国家: 美国
• 资助国家: 美国
• 起止时间: 至
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/6435361
• 关键词: behavioral /social science research tag; ethics; health care cost /financing; health care service evaluation; health insurance; health services research tag; managed care; terminal patient care

This project begins with the observation that most of the controversy about managed care, such as gag rules, financial incentives, limits on care, and confidentiality, can be viewed as ethics problems. It is unlikely that criticism, a patients bill of rights, or other approaches will get managed care organizations to be more ethical. The BEST project is based on the idea that by showing managed care plans a list of best practices regarding these ethical issues, they might adopt them. A consortium of 12 managed care plans was established, including for-profit, not-for-profit, academic, "Blues," and religious-based plans. Nine different ethical dimensions were identified: (1) community benefit, (2) care of vulnerable populations, (3) end-of-life care, (4) confidentiality, (5) organization ethics, (6) benefit design and adjudication, (7) technology assessment, (8) financial incentives, and (9) member disclosure and participation. So far, four different site visits have been completed and preliminary "best practices" have been identified for a number of areas. A conference delineating best practices was held in February 2000.

该项目首先观察到有关管理式医疗的大多数争议，例如禁言规则、经济激励、医疗限制和保密性，都可以被视为道德问题。批评、患者权利法案或其他方法不太可能使管理式医疗组织变得更加道德。 BEST 项目的理念是，通过向管理式医疗计划展示有关这些道德问题的最佳实践列表，他们可能会采用它们。一个由 12 个管理式医疗计划组成的联盟成立了，其中包括营利性、非营利性、学术性、“蓝调”和基于宗教的计划。确定了九个不同的道德维度：（1）社区利益，（2）弱势群体护理，（3）临终关怀，（4）保密性，（5）组织道德，（6）利益设计和裁决，（7）技术评估，（8）经济激励，以及（9）成员披露和参与。到目前为止，已经完成了四次不同的实地考察，并为许多领域确定了初步的“最佳实践”。 2000 年 2 月召开了一次描述最佳实践的会议。