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首页> 外文期刊>Transactions of the American Ophthalmological Society. >A value analysis model applied to the management of amblyopia.
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A value analysis model applied to the management of amblyopia.

机译：价值分析模型应用于弱视治疗。

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PURPOSE: To assess the value of amblyopia-related services by utilizing a health value model (HVM). Cost and quality criteria are evaluated in accordance with the interests of patients, physicians, and purchasers. METHODS: We applied an HVM to a hypothetical statistical ("median") child with amblyopia whose visual acuity is 20/80 and to a group of children with amblyopia who are managed by our practice. We applied the model to calculate the value of these services by evaluating the responses of patients and physicians and relating these responses to clinical outcomes. RESULTS: The consensus value of care for the hypothetical median child was calculated to be 0.406 (of 1.000). For those children managed in our practice, the calculated value is 0.682. Clinically, 79% achieved 20/40 or better visual acuity, and the mean final visual acuity was 0.2 logMAR (20/32). Value appraisals revealed significant concerns about the financial aspects of amblyopia-related services, particularly among physicians. Patients rated services more positively than did physicians. CONCLUSIONS: Amblyopia care is difficult, sustained, and important work that requires substantial sensitivity to and support of children and families. Compliance and early detection are essential to success. The value of amblyopia services is rated significantly higher by patients than by physicians. Relative to the measured value, amblyopia care is undercompensated. The HVM is useful to appraise clinical service delivery and its variation. The costs of failure and the benefits of success are high; high-value amblyopia care yields substantial dividends and should be commensurately compensated in the marketplace.
机译：目的：通过利用健康价值模型（HVM）评估弱视相关服务的价值。成本和质量标准根据患者，医生和购买者的利益进行评估。方法：我们将HVM应用于视力为20/80的假设统计（“中位数”）弱视儿童和由我们的实践管理的一群弱视儿童。我们通过评估患者和医生的反应并将这些反应与临床结果联系起来，应用该模型来计算这些服务的价值。结果：假设中位儿童的照料共识值为0.406（1.000）。对于按照我们的实践管理的孩子，计算得出的值为0.682。临床上，有79％的人的视力达到20/40或更高，平均最终视力为0.2 logMAR（20/32）。价值评估表明，人们对弱视相关服务的财务方面存在重大担忧，特别是在医生中间。与医生相比，患者对服务的评价更高。结论：弱视护理是一项艰巨，持续且重要的工作，需要对儿童和家庭的高度敏感性和支持。合规性和及早发现对于成功至关重要。与患者相比，患者对弱视服务的价值明显更高。相对于测量值，弱视保健的补偿不足。 HVM对评估临床服务交付及其变化很有用。失败的代价和成功的好处很高;高价值的弱视治疗可带来可观的收益，应在市场上得到相应的补偿。

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