在管理竞争下估计医疗支出增长. 科学,模拟和场景
1Institute for Health and Aging, University of California, San Francisco 94109.
JAMA
|February 22, 1995
概括
卫生系统改革影响了卫生支出. 新的情景显示,管理护理和竞争可能会显著降低医疗支出增长率 (HEGR),与此前的估计相反.
科学领域:
- 卫生经济学 卫生经济学
- 医疗保健服务研究 医疗服务研究
- 政策分析 政策分析
背景情况:
- 评估卫生系统改革对卫生支出的影响对于政策辩论至关重要.
- 医疗支出增长率 (HEGR) 预测显著影响长期财务前景.
- 目前的模型缺乏强有力的科学依据来评估托管护理对HEGR的影响.
研究的目的:
- 探索管理护理和市场发展对医疗支出增长率 (HEGR) 的影响的替代情景.
- 挑战现有的定性情景,预测管理护理对HEGR的影响最小.
- 倡导改进的模拟模型,纳入市场趋势和不确定性.
主要方法:
- 开发研究未来卫生系统发展的定性场景.
- 分析当前卫生系统变化,立法和管理护理之间的潜在相互作用.
- 批评医疗支出预测现有的建模方法.
主要成果:
- 以前的模型表明,管理护理/竞争对HEGR的影响很小或不存在.
- 其他可信的情景表明,管理护理/竞争可以大幅降低HEGR.
- 在定性场景预测和潜在的市场驱动结果之间存在重大差异.
结论:
- 管理护理和市场竞争具有相当大的潜力,可以降低医疗支出增长率 (HEGR).
- 模拟模型必须涵盖更广泛的估计范围,以反映市场动态和改革不确定性.
- 政策决策应考虑卫生系统改革对潜在经济影响的更广泛范围.
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