The role of financial incentives in shaping clinical practice patterns and practice efficiency.
Current Focus in Treating and Managing Coronary Artery Disease and Heart Failure. Symposium. Ft Lauderdale, FL, USA, 1997/01/15.
The US healthcare system is evolving from one in which most providers have been paid on some variation of a fee-for-service basis to one in which many or most providers will be paid on a capitated basis.
Will this change in financial incentives make a difference in how coronary artery disease and heart failure are treated and managed ?
Although the evidence is equivocal and limited, two recent studies suggest that capitation and other global payment incentives may dramatically alter clinical practice patterns in treating cardiovascular disease and substantially reduce cardiac-care costs.
Clinical cost-effectiveness research efforts must be intensified.
Thought leaders in the field of cardiology must move forcefully in developing, disseminating, and encouraging cardiac-care providers to accept and implement evidence-based clinical practice guidelines.
The alternative may be ill-advised tradeaffs decided in a decentralized, competitive marketplace, with algorithms being developed de facto by individual practitioners or groups in response to capitated reimbursement constraints.
The resulting practice could reduce healthcare use and spending without being cost-effective.
Unexpected and undesirable health outcomes could ensue.
Mots-clés Pascal : Cardiopathie coronaire, Insuffisance cardiaque, Système santé, Analyse coût efficacité, Economie santé, Financement, Mode, Traitement, Homme, Appareil circulatoire pathologie, Cardiopathie
Mots-clés Pascal anglais : Coronary heart disease, Heart failure, Health system, Cost efficiency analysis, Health economy, Financing, Mode of operation, Treatment, Human, Cardiovascular disease, Heart disease
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Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0058701
Code Inist : 002B12A03. Création : 14/05/1998.