医疗负担激增背景下低价值医疗的国际研究进展

Advances in International Research on Low-Value Healthcare in the Context of the Surge in Medical Burdens

目的:系统介绍低价值医疗的国际研究进展,为减轻我国卫生支出负担提供参考。方法:运用文献综述法,对“明智选择”运动、“DO NOT DO”、价值评价框架等国际实践经验进行综合分析,总结低价值医疗的主流识别方法与干预手段。结果:将低价值医疗国际实践总结为两种类型——以临床专业协会为主导的专家共识所形成的“负面清单”与以净健康效益为主的价值框架。归纳了两种研究类型的概念、特征、机制、不足等内容。结论:提出低价值医疗的治理建议;完善临床标准化路径;使用大数据工具;提高患者参与度与信任度。

Objective:It systematically introduces the international research progress of low-value healthcare,so as to provide references for reducing the burden of national health expenditure.Methods:Literature review is used to comprehensively analyze the international practice experiences of the Wise Choice Movement. "DO NOT DO" and value evaluation framework,and summarize the mainstream identification methods and intervention methods of low-value healthcare.Results:The international practice of low-value medicine can be summarized into the "negative list" formed by expert consensus led by clinical professional associations and the value framework based on net health benefits.The concepts,characteristics,mechanisms and deficiencies of the two types of research are summarized.Conclusion:It provides suggestions for low-value healthcare;improving the clinical standardization path;using big data tools;improving patient engagement and trust.