7662. Using Behavioral Economics to Design Physician Incentives That Deliver High-Value Care.
作者: Ezekiel J Emanuel.;Peter A Ubel.;Judd B Kessler.;Gregg Meyer.;Ralph W Muller.;Amol S Navathe.;Pankaj Patel.;Robert Pearl.;Meredith B Rosenthal.;Lee Sacks.;Aditi P Sen.;Paul Sherman.;Kevin G Volpp.
来源: Ann Intern Med. 2016年164卷2期114-9页
Behavioral economics provides insights about the development of effective incentives for physicians to deliver high-value care. It suggests that the structure and delivery of incentives can shape behavior, as can thoughtful design of the decision-making environment. This article discusses several principles of behavioral economics, including inertia, loss aversion, choice overload, and relative social ranking. Whereas these principles have been applied to motivate personal health decisions, retirement planning, and savings behavior, they have been largely ignored in the design of physician incentive programs. Applying these principles to physician incentives can improve their effectiveness through better alignment with performance goals. Anecdotal examples of successful incentive programs that apply behavioral economics principles are provided, even as the authors recognize that its application to the design of physician incentives is largely untested, and many outstanding questions exist. Application and rigorous evaluation of infrastructure changes and incentives are needed to design payment systems that incentivize high-quality, cost-conscious care.
7663. Prevention of Hepatitis C by Screening and Treatment in U.S. Prisons.
作者: Tianhua He.;Kan Li.;Mark S Roberts.;Anne C Spaulding.;Turgay Ayer.;John J Grefenstette.;Jagpreet Chhatwal.
来源: Ann Intern Med. 2016年164卷2期84-92页
The prevalence of hepatitis C virus (HCV) in U.S. prisoners is high; however, HCV testing and treatment are rare. Infected inmates released back into society contribute to the spread of HCV in the general population. Routine hepatitis screening of inmates followed by new therapies may reduce ongoing HCV transmission.
7665. Hepatitis B Virus Reactivation and Prophylaxis During Solid Tumor Chemotherapy: A Systematic Review and Meta-analysis.
作者: Sonali Paul.;Akriti Saxena.;Norma Terrin.;Kathleen Viveiros.;Ethan M Balk.;John B Wong.
来源: Ann Intern Med. 2016年164卷1期30-40页
Solid tumor chemotherapy regimens pose a risk for hepatitis B virus (HBV) reactivation, but screening and antiviral prophylaxis remains controversial because of insufficient evidence.
7666. Improving Adherence to Therapy and Clinical Outcomes While Containing Costs: Opportunities From the Greater Use of Generic Medications: Best Practice Advice From the Clinical Guidelines Committee of the American College of Physicians.
The discrepancy between health care spending and achieved outcomes in the United States has fueled efforts to identify and address situations where unnecessarily expensive therapies are used when less costly, equally effective options are available. The underuse of generic medications is an important example.
7670. Long-Term Health Outcomes in Women With Silicone Gel Breast Implants: A Systematic Review.
作者: Ethan M Balk.;Amy Earley.;Esther A Avendano.;Gowri Raman.
来源: Ann Intern Med. 2016年164卷3期164-75页
Silicone gel breast implants were removed from the U.S. market for cosmetic use in 1992 owing to safety concerns. They were reintroduced in 2006, with a call for improved surveillance of clinical outcomes.
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