为全人健康辩护。

Global advances in integrative medicine and health Pub Date : 2024-10-18 eCollection Date: 2024-01-01 DOI:10.1177/27536130241293642
Patricia M Herman, Mark H Pitcher, Helene M Langevin
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引用次数: 0

摘要

背景:我们传统的医疗保健方法倾向于将患者的健康按身体系统分开,对每个系统进行独立和 "有效 "的治疗--例如,尽量减少与医疗服务提供者接触的时间,依赖药物治疗,很少投资于支持行为和生活方式的改善。与此同时,美国是世界上医疗费用最昂贵的国家,但医疗效果却最差。目的 在本文中,我们提出了将医疗保健从以疾病为中心的方法转变为 "全人 "模式的理由。研究设计:我们提供了假定病人 M 女士从 40 岁到 80 岁期间在两种护理方案下的详细健康和医疗保健使用假设:传统护理方案(A 版)和全人护理方案(B 版)。分析 我们为每种方案制定了一套医疗保健使用假设,应用 2023 年美元资源价格,并估算了累计医疗保健总成本。我们使用医疗支出小组调查 (MEPS) 数据对传统护理方案的价格和医疗保健使用假设进行了验证。结果:M 女士 80 岁时,在接受传统护理的情况下,她的身体越来越虚弱,住在一家专业护理机构,累计医疗费用总额为 353,155 美元。通过全人护理,我们发现她在 80 岁时非常活跃,身体基本健康,累计医疗费用总额为 52,425 美元。结论:虽然是基于一个 "想象 "的病例,但 M 女士的两个病史版本说明了如何从中年早期开始投资,支持健康饮食、体育锻炼和压力管理,从而改善健康和福祉,降低医疗费用。
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Making a Case for Whole Person Health.

Background: Our conventional approach to health care tends to separate patients' health by body system, treating each independently and "efficiently"-e.g., minimal time with a provider, reliance on medications, and little investment to support behavioral and lifestyle improvements. Meanwhile, the United States has the most expensive health care in the world, with some of the worse outcomes. Purpose In this paper, we make the case for transforming health care from a disease-centric approach to a "whole person" model. Research Design: We provide detailed health and health care utilization assumptions for a hypothetical patient, Mrs. M, over her life from age 40 to 80 years under 2 care scenarios: the continuation of conventional care (Version A) and a whole person care approach (Version B). Analysis We developed a set of health care utilization assumptions for each scenario, applied 2023 U.S. dollar (USD) resource prices, and estimated cumulative total health care costs. The price and the health care utilization assumptions for the conventional care scenario were validated using Medical Expenditures Panel Survey (MEPS) data. Results: At age 80, with conventional care, we find Mrs. M increasingly frail and living in a skilled nursing facility, with total cumulative health care costs of $353,155. With whole person care, we find her active and generally healthy at age 80, with total cumulative health care costs of $52,425. Conclusions: Although based on an "imagined" case, the 2 versions of Mrs. M's history illustrate how an investment beginning in early middle age to support a healthy diet, physical activity, and stress management can plausibly lead to improved health and well-being, as well as reduced health care spending.

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