马里兰州的经验和一个实际的建议,以扩大现有的模型在门诊初级保健
W A Riley1, W A Schneckenburger
1Department of Medicine, Greater Baltimore Medical Center, MD 21204.
JAMA
|August 28, 1991
概括
马里兰 马里兰 马里兰
科学领域:
- 卫生经济学 卫生经济学
- 医疗保健政策 医疗保健政策
- 初级保健模式的初级保健模式
背景情况:
- 马里兰州有两个不同的医疗保健提供模式,用于未保险和未保险人口.
- 一个模型是初级保健小组实践与医疗保险豁免,使患者和医生受益.
- 第二个是金融模式,一个全付款人预期定价系统,用于住院医院.
研究的目的:
- 分析马里兰州两种独特的医疗保健融资和提供模式的成功情况.
- 提出一个合并的模型,整合两个现有系统的优势.
- 创建一个实际和政治上可行的医疗保健解决方案.
主要方法:
- 一个小组实践的审查,初级保健模式与门诊医疗保险豁免.
- 分析了13年的财务数据 (1977-1989) 来自一个全付款人前性利率设定系统.
- 对每个模型的成功因素进行讨论,以告知新的提案.
主要成果:
- 初级保健模式对患者和医生产生了积极的影响.
- 全付费系统在1977-1989年间为马里兰州公民节省了53.61亿美元.
- 医院提供了1657亿美元的慈善护理和不良债务,取了5.17亿美元的利.
结论:
- 两种模型的成功归因于它们独特的结构.
- 提出了一项建议,将两种模式的最佳方面合并在一起.
- 推的模式是基于门诊初级保健,由全付费者未来收费系统资助.
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