TECHNOLOGY-ASSESSMENT AND SUPPORT OF LIFE-SUSTAINING DEVICES IN-HOME CARE - THE HOME CARE PHYSICIAN PERSPECTIVE

被引:11
作者
GOLDBERG, AI
机构
[1] Department of Pediatrics, Loyola University Medical Center, Maywood, IL 60153
关键词
D O I
10.1378/chest.105.5.1448
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Practicing physicians are increasingly using life-sustaining devices in the home setting for patients with long-term needs due to chronic conditions. At the same time, public policy focus on technology assessment has broadened from narrow medical concerns about safety and efficacy to considerations of effectiveness, quality of life, patient preferences, and cost/benefit. Around the world high-technology home care (HTHC) features a number of ways to evaluate outcomes. One category of HTHC that requires initial and on-going technology assessment is home mechanical ventilation (HMV). Home MV has developed in nations with a variety of healthcare finance systems: England (national health system), France (national health insurance), and the United States (regulated/market-economy). Approaches to technology assessment differ among nations according to organizational design and evolution. Physician behavior is a major determinant in the application of medical technologies. There are new physician roles that can influence what, when, and how technology is appropriately used in the home-initially and over time. For this reason, it is crucial to consider the role of the practicing physician in home care technology assessment.
引用
收藏
页码:1448 / 1453
页数:6
相关论文
共 34 条
[1]   THE CASE FOR REASSESSMENT OF HEALTH-CARE TECHNOLOGY - ONCE IS NOT ENOUGH [J].
BANTA, HD ;
THACKER, SB .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 1990, 264 (02) :235-240
[2]   HIGH-TECH PREDICAMENT - PULMONARY-ARTERY CATHETER [J].
BONE, RC .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 1990, 264 (22) :2933-2933
[4]   THE NEW TECHNOLOGY-ASSESSMENT [J].
FUCHS, VR ;
GARBER, AM .
NEW ENGLAND JOURNAL OF MEDICINE, 1990, 323 (10) :673-677
[5]  
GINSBERG E, 1984, HOME HLTH CARE ITS R
[6]  
GOLDBERG A I, 1990, Respiratory Care, V35, P247
[7]   HOME HEALTH-CARE FOR CHILDREN ASSISTED BY MECHANICAL VENTILATION - THE PHYSICIANS PERSPECTIVE [J].
GOLDBERG, AI ;
MONAHAN, CA .
JOURNAL OF PEDIATRICS, 1989, 114 (03) :378-383
[8]   HOME CARE FOR A BETTER LIFE FOR VENTILATOR-DEPENDENT PEOPLE [J].
GOLDBERG, AI .
CHEST, 1983, 84 (04) :365-366
[9]   CARING FOR MECHANICALLY VENTILATED PATIENTS AT HOME [J].
GOLDBERG, AI ;
ALBA, AA ;
OPPENHEIMER, EA .
CHEST, 1990, 98 (06) :1543-1543
[10]   HOME CARE FOR LIFE-SUPPORTED PERSONS - IS A NATIONAL APPROACH THE ANSWER [J].
GOLDBERG, AI .
CHEST, 1986, 90 (05) :744-748