在过渡期的初级保健
1Department of Medicine, University of California Medical Center, San Francisco.
JAMA
|November 16, 1994
概括
由于管理护理和报销问题,初级保健医生的供应正在下降. 建议的解决方案包括单独的费用表和预算,以支持初级保健实践.
科学领域:
- 卫生政策 卫生政策
- 医学经济学 医学经济学
- 初级医疗保健医学 一级医疗保健医学
背景情况:
- 在初级保健中缺乏医生是一个公认的问题.
- 管理护理和基于资源的相对价值表 (RBVS) 的实施对初级保健医生产生了负面影响.
- 初级保健医生面临的挑战是,与专家相比,他们的财富,影响力和人数较低.
研究的目的:
- 分析当前医疗保健趋势对初级保健医生的影响.
- 提出保护和增强初级保健实践和医生供应的战略.
主要方法:
- 对影响初级保健的医疗保健政策和经济因素的定性分析.
- 审查现有的报销模式和管理护理结构.
- 识别对初级保健医生的招聘和保留障碍.
主要成果:
- 管理护理和RBVS实施对初级保健医生产生了意想不到的负面影响.
- 初级保健医生在与付款人以及同行之间的谈判中处于不利地位.
- 目前对初级保健的支持可能不足或肤浅.
结论:
- 建议在健康计划中制定单独的初级保健费用表和预算.
- 建议对影响初级保健的消费者保护规则进行修改.
- 建议发展全州初级保健协会,以增加谈判力和相互支持.
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