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Zowall Hanna (McGill University, Montreal, Canada), Brewer Carl (Zowall Consulting Inc. Health Economics and Outcomes Research, Montreal, Canada), Deutsch Antal (McGill University, Montreal , Canada)
Reengineering Health Care: Questionable Medical Tests and Procedures
Journal of Health Policy and Outcomes Research, 2013, nr 1, s. 4-25, rys., tab., bibliogr. 20 poz.
Słowa kluczowe
Opieka zdrowotna, Medycyna
Health care, Medicine
Given current and future budgetary constraints, issues of what constitute appropriate level of care are becoming paramount. More evidence-based data are accumulated, identifying the appropriate use of medical tests and procedures becomes imperative. In the United States, the "Choosing Wisely" campaign is an initiative of the American Board of Internal Medicine Foundation to allow physicians to be leaders in better management of fi nite health care resources. As part of a campaign, each participating medical specialty society has created lists of "Things Physicians and Patients Should Question" that provide specific, evidence-based recommendations, so physicians and patients can reach informed decisions about the appropriate level of care. Here we provide the summary of the most important recommendations. The aim of this paper is to disseminate the information in order to stimulate discussions about the appropriateness of frequently ordered tests or treatments and about variations in patterns of care, and cost-eff ective ways of managing fi nite health care resources. Central to the best practice of medicine becomes comparative-effectiveness research, including long term studies on clinical benefi ts and costs. Physicians must change practice patterns, through standard-of-practice guidelines, to practice in the most knowledge-based, least invasive, and less costly way. Physicians need to take a leadership role in teaching patients that more medicine is not better medicine, that costly eff orts do not equal better health care. We need to explain to patients that new medical technology must be used with care and wisdom. (original abstract)
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