No toyotas in health care: Why medical care has not evolved to meet patients' needs
No toyotas in health care: Why medical care has not evolved to meet patients' needs
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DOI：
10.1377/hlthaff.20.6.44
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发表时间：
2001-11-01
期刊：
影响因子：
9.7
通讯作者：
Coye, MJ
中科院分区：
文献类型：
--
作者：
Coye, MJ
美国医疗保健的激励机制和结构恰恰产生了我们对慢性病护理质量的期望：高度可变的护理模式和普遍未能实施循证最佳实践。提供者在改进实践模式方面的持续无能部分是由于缺乏“质量的商业案例”。供应商不能预料到质量的提高将导致更高的价格、增加的数量或降低的成本。然而，在成本压力、数据可用性增加、知情消费者以及公共和私营部门采购计划的推动下，质量商业案例的迹象正在出现。
The incentives and structure of health care in the United States produce exactly what we should expect in the quality of care for chronic disease: highly variable patterns of care and widespread failure to implement evidence-based best practices. The persistent inability of providers to improve patterns of practice is due in part to the lack of a "business case for quality." Providers cannot anticipate that quality improvements will result in higher prices, increased volume, or decreased costs. However, signs of a business case for quality are emerging, fueled by cost pressures, the increased availability of data, informed consumers, and public- and private-sector purchaser initiatives.