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Estimación del crecimiento del gasto en salud bajo competencia gestionada. Ciencia, simulaciones y escenarios
1Institute for Health and Aging, University of California, San Francisco 94109.
JAMA
|February 22, 1995
Resumen
La reforma del sistema de salud afecta el gasto en salud. Los nuevos escenarios muestran que la atención administrada y la competencia podrían reducir significativamente la tasa de crecimiento del gasto en salud (HEGR), contrariamente a las estimaciones anteriores.
Área de la Ciencia:
- Economía de la salud Economía de la salud
- Servicios de salud Servicios de salud Investigación Investigación.
- Análisis de políticas Análisis de políticas.
Sus antecedentes:
- Estimar el impacto de la reforma del sistema de salud en los gastos de salud es crucial para los debates políticos.
- Las proyecciones de la tasa de crecimiento del gasto en salud (HEGR) influyen significativamente en las perspectivas financieras a largo plazo.
- Los modelos actuales carecen de una sólida base científica para evaluar el efecto de la atención administrada en el HEGR.
Objetivo del estudio:
- Explorar escenarios alternativos para el impacto de la atención administrada y la evolución del mercado en la tasa de crecimiento del gasto en salud (HEGR).
- Desafiar los escenarios cualitativos existentes que predijeron un impacto mínimo de la atención administrada en HEGR.
- Abogar por modelos de simulación mejorados que incorporen las tendencias del mercado y la incertidumbre.
Principales métodos:
- Desarrollo de escenarios cualitativos que examinen los desarrollos futuros del sistema de salud.
- Análisis de las posibles interacciones entre los cambios actuales en el sistema de salud, la legislación y la atención administrada.
- Crítica de los enfoques de modelado existentes para la previsión del gasto en salud.
Principales resultados:
- Los modelos anteriores sugerían que la atención administrada / competencia tendría poco o ningún impacto en HEGR.
- Los escenarios alternativos plausibles demuestran que la atención administrada / competencia puede reducir sustancialmente el HEGR.
- Existen discrepancias significativas entre las predicciones cualitativas de escenarios y los posibles resultados impulsados por el mercado.
Conclusiones:
- La atención administrada y la competencia en el mercado tienen un potencial sustancial para reducir la tasa de crecimiento del gasto en salud (HEGR).
- Los modelos de simulación deben abarcar una gama más amplia de estimaciones para reflejar la dinámica del mercado y las incertidumbres de las reformas.
- Las decisiones políticas deben considerar un espectro más amplio de posibles impactos económicos de las reformas del sistema de salud.
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