Martin K. Schmid, Dawn A. Sim, Stefan Boes, Thomas J. Wolfensberger, Lucas M. Bachmann, Katja Hatz, Michael A. Thiel
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引用次数: 0
Abstract
The seminal work of Wennberg and Gittelsohn in 1973 emphasised the importance of health information for informed decision-making. This led to the creation of the Dartmouth Health Atlas in 1996, which has become an important resource for monitoring health services in the USA. The Dartmouth Health Atlas research revealed the existence of variation in health care without benefit to patients, and the dependence of health care use on local resource supply. Similar initiatives emerged around the world, from the UK to Asia. The availability of administrative data has become essential for evaluating health service delivery and for informing health economic analysis and policy decisions. Access to data depends on the organisation of the health system, with more centralised systems facilitating comprehensive data collection. We contrast the decentralised structure of the Swiss healthcare system with that of the US and the UK, and highlight the challenges of harmonising data for nationwide health monitoring. The example of optical coherence tomography (OCT) in Swiss ophthalmology illustrates the variability in care practices and billing patterns. This variability can be attributed to the lack of clear guidelines and the complexity of billing codes. Incentives to charge incorrect rates influence billing, adding a further variance component to the variance in care that cannot be subtracted from the total variance at the level of a health insurance fund and distorting the results. In certain environments the quality of data on care is so variable that a sound conclusions for health policy decisions represent a great challenge.
期刊介绍:
Eye seeks to provide the international practising ophthalmologist with high quality articles, of academic rigour, on the latest global clinical and laboratory based research. Its core aim is to advance the science and practice of ophthalmology with the latest clinical- and scientific-based research. Whilst principally aimed at the practising clinician, the journal contains material of interest to a wider readership including optometrists, orthoptists, other health care professionals and research workers in all aspects of the field of visual science worldwide. Eye is the official journal of The Royal College of Ophthalmologists.
Eye encourages the submission of original articles covering all aspects of ophthalmology including: external eye disease; oculo-plastic surgery; orbital and lacrimal disease; ocular surface and corneal disorders; paediatric ophthalmology and strabismus; glaucoma; medical and surgical retina; neuro-ophthalmology; cataract and refractive surgery; ocular oncology; ophthalmic pathology; ophthalmic genetics.