Achieving A High Performance Health Care System With Universal
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The document discusses lessons the U.S. can learn from other countries' healthcare systems. It outlines recommendations from the American College of Physicians for redesigning the U.S. system based on high-performing systems in other nations. These include ensuring all residents have access to affordable healthcare, using global budgets and cost savings, sharing authority between national and regional governments, controlling healthcare costs, investing in primary/preventive care and health professionals, and adopting policies focused on quality, coordination of care, and use of technology. While no system is perfect, following these recommendations could help address gaps in access, efficiency and outcomes in the U.S. system.
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崩散
藥品固體製劑在胃中當胃液滲透進入錠劑，潤濕後錠劑開始崩散，崩散成顆粒後因表面積增加，溶離速率大幅增快。因此 崩散 與 吸收、治療 效果存在相關性，崩散度試驗 即測定各種錠劑或膠囊劑是否能於規定時限內崩散，早在1950年 USP( <701> 、<2040>、Ph. Eur.) 就收錄提供錠劑崩散度測定方法。
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Achieving A High Performance Health Care System With Universal
- 1. Achieving a High-Performance Health Care System with Universal Access: What the U.S. Can Learn From Other Countries 美國該如何從其他國家的經驗中學習 如何提供高品質的醫療保險 報告人：B108096007 陳永嘉 B108096039 鄭丞恩
- 2. 大綱 • 前言：美國醫療保險概況 – 醫療費用的支出與收入 – 表現評估 • 比較：美國與各國之比較 • 可學習的課題 • 結論
- 3. 前言 美國醫療保險的概況 Health Care in United States
- 4. 美國醫療保險概況 – 納保率 – 資源分配 – 未來發展的需求 • 這篇paper的宗旨： 師夷之長
- 5. 美國醫療保險概況 • 納保率不高 • 資源分配不均 • 對未來的需求準備不足 84.2% 120萬 慢性病人口 150萬
- 6. 美國醫療保險概況 15% 醫療費用支出佔GDP的比例
- 7. 美國醫療保險概況 其他 藥品 醫院 診所 醫療費用支出比例
- 8. 美國醫療保險概況 • 資金來源 – 政府v.s.私人保險 – 軍人保險 • 自付額 • 醫師人力 • 科技與創新
- 9. 表現評估 Access Efficiency Quality Equity Criteria for Long, Healthy Capacity to a Well- and Productive Innovate and Life functioning Improve System
- 12. 比較 美國與各國之比較 The U.S. Health Care System Compared With That in Other Countries
- 13. 比較不同國家制度的困難 • 健康狀況的差異上會反映在經濟狀況、人 口組成、社會文化的差異 • 國際間的比較會因為各國定義、回報、解 讀資料的不同而有誤差
- 14. 比較不同國家制度的困難 • 跨國的便利讓人很難去界定健康結果的原 因歸屬 • 2005年，OECD和世衛組織達成協議，開 始收集歐盟和其他工業國家的健康狀況資 料。
- 15. 醫療照護的支出 • 美國的GDP有15.3%花費在醫療照護上，而 其他的工業國家平均是9.0%(8~11%之間)。 • 資源有限的情況下，過高的醫療費用支出 會壓縮其他重要的支出，例如說房貸、教 育資金、國防預算等。更會增加國家的財 政負債。
- 17. 行政(管理與監察)費用 • 界定管理費用的定義和方法有別，導致最 終的估計會有誤差 • 美國私人保險的行政費用高於加拿大或其 他工業國家的保險，以及美國政府的保險
- 19. 自付額 • 在美國，總醫療支 出的13.2%是來自 於病人的自付額。 這比例較加拿大的 14.9%來的低。
- 20. 不同國家的品質與健康結果 • 近來的問卷調查顯示，在幾個關鍵的衡量 上，美國的民眾對於自己的醫療保險制度 評價，較其他國家低
- 23. 醫療系統差異的可能原因 • 大部分表現良好的醫療照護都有很良好 的基礎照護 • 能夠掌控不同專科的醫師人力也是關鍵 • 使用電子病歷 – 美國尤其缺乏
- 24. 學習 最後星期二的十二堂課 Lessons From Other Countries and ACP Recommendations For Redesigning The U.S. Health Care System
- 25. 支付醫療費用 • 第一課： Well-functioning health systems all guarantee that all residents will have access to affordable health coverage for a defined set of benefits.
- 26. • 第二課： Global budgets • 第三課： Cost savings • 第四課： Countries that have federal systems in which national and regional governments share authority.
- 27. 控制醫療費用 • 第五課： The best systems ensure access to health care without financial barriers. • 第六課： Incentives to encourage personal responsibility for health can lead to healthy behaviors, improved health outcomes, and responsible utilization of health care services.
- 28. 醫事人力足以應付需求 • 第七課： Societal investment in health professional education. • 第八課： Investment in primary and preventive care can result in better health outcomes, reduce costs, and may better assure an adequate supply of primary care physicians.
- 29. 能夠鼓勵以病人為中心的政策 • 第九課： Effective physician payment systems include adequate payment for primary care services, incentives for quality improvement and reporting, recognizing geographic or local payment differences, and incentives for care coordination.
- 30. 衡量醫療品質 • 第十課： Performance measures, financial incentives, and active monitoring of performance are key elements of health systems that provide high- quality care.
- 31. 電子帳單與病歷 • 第十一課： Adoption of a uniform billing system and electronic processing of claims improves efficiency and reduces administrative expenses.
- 32. 掌握醫學新科技 • 第十二課： Insufficient investments in research and medical technology result in reliance on outdated technologies and medical equipment, and delay patients’ access to advances in medical science.
- 33. 結論 還有很大的進步空間 我的成會大概爆了 Summary and Conclusions