I. Specialized division of labor in medical services
In traditional medical service provision, medical services are only provided by hospitals and doctors' clinics, from medical consultation, laboratory tests, diagnosis, treatment to post-operative rehabilitation and chronic disease management, the above two types of institutions cover almost all functions, and this “big and comprehensive” organization has high operating costs, unclear main functions, and a large amount of costs invested in daily operations, rather than for the treatment of patients. This “big and comprehensive” organization has high operating costs and unclear main functions, and a lot of costs are invested in daily operation rather than patient treatment; while the emerging healthcare service model shows more specialization and division of labor, which disperses multiple functions into various organizations independent of each other, and with the help of ever-advancing information technology and diagnostic and treatment technology, provides patients with cheaper and more efficient services.
Simply by decentralizing diagnosis and treatment to different institutions, service efficiency can be significantly improved.
With the help of information technology, patients can upload their test results through the Internet and obtain accurate diagnosis from specialized doctors, while treatment can be done through microclinics, specialized hospitals, etc. On the basis of accurate diagnosis, the treatment of many diseases is just a controllable and replicable process, and physician assistants and even nurses can complete these treatments.
The United States has appeared a considerable part of the institutions dedicated to this, such as rapid clinics (RediClinic) and Minute Clinic (Minuteclinic, acquired by the U.S. drugstore chain CVS in 2007), Sholdice Hospital (Shouldice Hospital ) and other surgical specialty hospitals, as well as many eye surgery clinics, cardiology hospitals, cancer rehabilitation centers, etc. These treatment-focused organizations have begun charging patients a fixed fee based on individual procedures, as opposed to traditional hospitals that charge per item for all services. With uniformity of process and controlled risk, the resulting health care expenditures are clear and unambiguous. in September 2006, Geisinger Health System's ProvenCare program began charging a fixed rate for selected cardiac bypass surgeries, with a 90-day shelf life.
Clayton Christensen's research shows that these clinics, which offer only specific treatment services, are able to provide a comparable level of care at half the price compared to providers who offer both diagnosis and treatment. For the same treatment of external abdominal wall hernias, Shoredale Hospital admitted only a few types of external abdominal wall hernias, but used the same clinical pathway for all patients, with a total of only four days, relying on meal preparation on the first day, surgery on the second day, and recuperation on the third and fourth days, at a total cost of $2,300, with a near-vast majority of patient satisfaction rates, and near-zero costs for malpractice lawsuits; in contrast, at a North American general hospital in North America, the cost of the same procedure was $3,350 and was done on an outpatient basis; if the patient had been hospitalized, the cost would have been nearly $7,000.
Upper respiratory tract infections, sinusitis, pharyngitis and other common conditions can also be treated in microclinics, which are primarily nurse practitioners. Mary Kate Scott, an expert in the field of microclinics in the United States, statistics, in the right technical support, a total of 60 to 100 kinds of diseases can be dealt with by the microclinics, although limited in kind, but these diseases account for 17% of the diseases to see a family doctor in the United States, and microclinics to deal with the cost of these diseases, the cost of seeing a family doctor than the cost of 32% to 47% lower. Their convenience and lack of queuing also greatly reduces the time it takes for patients to get to the doctor and greatly improves patient satisfaction.
As caregivers will be enough to play a major role in the new medical service model, which greatly reduces the workload of doctors, doctors human resources can be more invested in specialized clinical diagnosis.
Cleveland Medical Center (The Cleveland Clinic) in the United States through the reorganization of the original center into a cross-disciplinary expert cooperation as a feature of the institution, such as in the Institute of Neurology to employ oncologists, radiologists, neurosurgeons, psychiatrists and psychologists, etc., and neurologists integrated with the neurologist to diagnose the cause of the patient's disease and the different types of disease as accurately as possible. In turn, the increasing precision of diagnosis promotes a better division of labor between diagnosis and treatment.
In addition, doctors can also leverage information technology to greatly expand the range of medical diagnoses they can provide.
In the traditional community, a general practitioner's service area is about 1,000 to 1,500 people, but in the new medical service model, patients no longer need to rely on face-to-face mode of medical care, doctors can use the Internet to provide services to patients from all over the world to make a diagnosis. In this new service model, the general practitioner team can expand their service scope to 5-10 times the original traditional model.
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