价值医疗理念下的医学营养疗法

Medical nutrition therapy in the context of value-based healthcare

价值医疗的目的是在全面提升医疗质量的基础上有效控制医疗成本,是我国医疗体制改革的重点内容。通过完善信息化系统建设,设定科学评价方法,改革医保支付方式是我国价值医疗实践的动力。“筛查、评定、干预”是规范化医学营养管理的关键步骤,营养风险筛查以改善临床结局为目标,符合价值医疗的内涵;全球营养领导层倡议营养不良诊断标准下的营养不良诊断为进入国家(疾病)诊断相关分类奠定了基础;口服营养补充是存在营养风险或营养不良,且进食不足患者首选的医学营养治疗方式,规范应用可减少体重丢失,改善临床结局,节省医疗费用,可以较低的成本改善营养不良老年患者的健康和生存,是体现价值医疗的典范。

The purpose of value-based healthcare is to effectively control medical costs on the basis of comprehensively improved healthcare quality,which is the key focus of medical system reform in China.Improving information system framework,establishing scientific evaluation methods and transforming medical insurance payment methods are the impetus for value-based healthcare practice in China."Screening,assessment and intervention"is the critical step in standardized medical nutrition management.In line with the connotation of value-based healthcare,nutritional risk screening aims to improve clinical outcomes.The diagnosis of malnutrition per the Global Leadership Initiative on Malnutrition(GLIM)criteria enables the inclusion into Diagnosis Related Groups(DRGs).Oral nutritional supplement is the preferred medical nutrition treatment for patients at nutritional risk or with malnutrition and insufficient food intake.Standardized application can reduce weight loss,improve clinical outcomes,save medical costs and improve the health and survival of malnourished elderly patients at a lower cost,exemplifying the value-based healthcare model.