价值营养治疗--从价值医疗看临床营养

Value-based nutrition therapy:clinical nutrition from the value-based care perspective

价值医疗的核心理念是强调医疗服务的质量和性价比,为患者创造价值,全流程全人服务。以人为本、以患者为中心、个体化医疗、精准医疗是价值医疗的基石。终极目标是维护患者的利益最大化。本文首次讨论价值医疗在临床营养中的应用,即价值营养治疗,并从加强临床营养学科建设,建设无饿医院,改变观念、还营养为一线治疗地位,组建多学科营养治疗团队,落实入院营养诊断,实施早期、规范、精准营养治疗,研发更加丰富多样的营养制剂,重视卫生经济学效益,加强营养治疗效果评价与随访等方面,探讨如何通过营养治疗实现价值医疗目标。笔者认为,在临床医疗实践中,要牢固树立营养一线治疗观念,充分发挥营养治疗作用,改善临床结局、节约医疗费用双重作用,进一步发挥营养治疗的价值医疗作用。营养治疗是价值医疗的有效载体,价值营养治疗是价值医疗的良好体现。

Value⁃based care(VBC)emphasizes the quality and cost⁃effectiveness of medical care,creating value and providing comprehensive services throughout the course.Person⁃centered care,patient⁃centered care,personalized medicine,and precision medicine lay the foundation of VBC.The ultimate goal of VBC is to maximize the patient’s benefit.In this paper,we discussed the application of VBC on clinical nutrition,namely value⁃based nutrition therapy,and its importance in realizing VBC from the following aspects:boost the discipline of clinical nutrition;set up hungry free hospitals;change the perception of nutrition therapy and recognize it as first⁃line therapy;organize multi⁃disciplinary teams for nutrition therapy;deliver nutritional diagnosis at admission;provide early,standardized,precise nutrition therapy;develop more nutritional formula;value health economic benefits;enhance efficacy evaluation of nutrition therapy and follow⁃ups.In practice,we should concrete the concept of“nutrition is a first⁃line therapy”,as nutrition therapy has a dual role in improving health outcomes and saving medical costs.Nutrition therapy is a good vehicle for and reflection of VBC.