拉脱维亚准备好迎接基于价值的医疗保健时代了吗?

Mara Petersone, I. Erins, Kārlis Ketners
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摘要

以价值为基础的保健(VBHC)最近已成为世界上主要的保健概念方法,但拉脱维亚尚未建立以价值为基础的保健方案。尽管卫生部门的利益攸关方对实施身心健康方案非常感兴趣,但身心健康方案的关键人员仍然是医生。研究目标:澄清医生和年轻医生对基于价值观的卫生保健基本原则的看法,以及他们对进一步纳入拉脱维亚卫生保健的看法。方法:本研究使用了一项调查数据,调查对象是在paul Stradins临床大学医院执业的医生和年轻医生。结果:42%的医生认为对某些患者群体的治疗效果进行患者调查有助于改善治疗效果;51%的医生回应说,患者对其治疗经历的调查有助于改善其治疗效果;在比较医生团队/医院之间的治疗结果是否有助于改善结果的问题上,医生们要谨慎得多——39%的人回答“是”,24%的人回答“是而不是否”;对医疗机构自愿向公众提供治疗结果是否会对服务提供者的知名度产生积极影响的回答也同样谨慎————31%的人回答"是",25%的人回答"相当是";令人信服的82%的答复是关于医生团队中经验和知识的交流是否有助于改善治疗结果的问题;令人信服的86%的医生认为,多学科的医生团队可以帮助改善治疗效果;作为一项积极的答复,可以认为63%的答复者认为保健改革不仅可以由卫生部发起。最有趣的答案是在医疗保健系统中应该制定什么样的管理策略,在这个问题上,“与外部合作伙伴(制造商、科学中心、保险公司、IT和其他服务提供商)的合作”以349分名列第一。结论:调查结果表明,VBHC原则的应用不会与医生对传统医疗管理模式及其在其中的作用的看法相矛盾。建议:然而,在开始在拉脱维亚卫生保健中引入VBHC方案之前,有理由就VBHC与传统管理模式相比的好处展开讨论。政策建议:为了使医院管理和卫生部门监督者避免医生抵制实施VBHC,该战略不应侧重于VBHC资源效率方案,而应侧重于以患者为中心的保健。
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Is Latvia Ready For The Value-Based Healthcare Era?
The Value Based Health Care (VBHC) has recently become the leading conceptual approach to health care in the world, but no value-based healthcare programme has yet been established in Latvia. Despite the critical interest in the implementation of VBHC programmes on the part of the health sector stakeholders, still the key persons in VBHC programmes are physicians. Goal of research: To clarify the views of physicians and young physicians on values-based health care fundamental principles and their vision for their further inclusion in Latvian health care. Method: The research uses data from a survey conducted among physicians and young physicians who practice at Pauls Stradins Clinical University Hospital.Results: 42% of physicians responded that patient surveys on the effectiveness of treatment for certain groups of patients could help to improve the results of treatment; 51% of physicians responded that patient surveys on their experience during treatment can help to improve their treatment results; much more cautious were physicians regarding the question whether comparing the results of treatment between physicians teams/hospitals could help to improve the results – 39% replied ‘Yes’ and 24% ‘Rather yes than no’; similarly cautious was the reply to the question whether the voluntary public availability of treatment results from a medical treatment facility could have a positive impact on the visibility of the service provider – 31% replied ‘Yes’ and 25% ‘Rather yes’; the convincing 82% of replies were to the question whether an exchange of experience and knowledge in the team of physicians helps to improve the results of treatment; the convincing majority of 86% of physicians believe that a multidisciplinary team of physicians can help improve the results of treatment; as a positive response, can be considered that 63% of respondents think that reforms in health care may be initiated not only by the Ministry of Health. The most interesting answer would be to the question of what management strategies should be developed in the healthcare system, where the first place, with 349 points, was taken by the answer “Cooperation with external partners (manufacturers, scientific centres, insurers, IT and other service providers)”.Conclusions: The results of the survey show that the application of VBHC principles will not contradict to views of physicians on traditional management models in health care and their role in it.Proposals: However, prior to starting the introduction of VBHC programmes in Latvian health care, there are grounds for launching discussions on the benefits of VBHC compared to the traditional management model. Policy recommendations: For hospital management and health sector supervisors to avoid resistance of physicians to implementing VBHC, the strategy should focus not on VBHC resource-efficient programmes but on patient-centred healthcare.
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