国际医疗领域“明智选择”运动的进展及其对我国的启示

Progress of the'Choosing Wisely'Campaign in the Field of International Healthcare and Its Implications to China

为应对低价值医疗服务泛滥导致的医疗费用快速增长问题,国际上开展了“明智选择”(choosing wisely)运动,旨在促进医患交流,通过制定低价值医疗服务清单,帮助患者选择合适的医疗服务。本研究综述了医疗领域“明智选择”运动的进展、五大运动原则、低价值医疗服务清单制作过程、减少低价值医疗服务的措施以及对我国的启示。卫生部门应牵头组织行业协会制定并公布低价值医疗服务清单,医保部门应借鉴按价值支付经验,同时不断提高患者信息可及性,加强对医生的临床决策和法律支持。

In order to cope with the rapid increase in medical expenses caused by the proliferation of low value care,the choosing wisely campaign has been launched internationally,aiming to promote physician-patient communication and help patients choose appropriate medical services by developing a list of low value care.This study reviews the progress of the choosing wisely campaign,the five principles of the movement,the process of creating the'top 5'lists of low value care,measures to reduce low value care,and the implications for China.This study suggests that the health department should take the lead in organizing industry associations to develop and publish the'top 5'lists of low value care.The medical insurance department should draw on the experience of value-based payment,while continuously improving the accessibility of patient information and enhancing clinical decision-making and legal support for physicians.