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据1983年资料记载,维斯康辛家庭卫生保健机构对家庭卫生保健的平均费用与享受家庭卫生保健机构病人的病种构成之间的相互关系进行了首次调研。该机构通过评价过去该项工作中使用的方法,探讨了过去研究与今日研究的差别,得出一个与以往截然相反的结果,即:病种构成极大地影响了家庭卫生保健机构的平均费用。同时还得出,平均费用随产值的降低而减少、随享受该机构服务的自费病人所占比例的提高而增加。估计,如果家庭卫生保健机构设置在市区内,或该机构享有专利营业权,那么,平均费用将会增高。与此研究有关的是,要探讨出相应的家庭卫生保健的补偿政策。为此,争议的首要问题是,尽管进一步的研究已逐步证实了平均费用与家庭卫生保健机构的病种构成有关,但人们仍还不能明确得出这一结论,即正如目前许多州对疗养院进行补偿那样,去调节不同病种构成的补偿率。因此,政府在制定政策时,一定要考虑到家庭卫生保健机构与疗养院之间的根本区别,要考虑到双方各自的医疗市场。否则,将影响到政策实施的有效性。
According to records in 1983, the Wisconsin Family Health Care Organization conducted the first research on the relationship between the average cost of family health care and the patient’s disease composition in the family health care institutions. The agency, by evaluating the methods used in the past work, explored the differences between past research and today’s research and came up with a diametrically opposed result: the disease composition has greatly affected the average cost of family health care institutions. At the same time, it was also concluded that the average cost decreased with the decrease of the output value and increased with the increase in the percentage of self-paid patients who served with the institution. It is estimated that if the family health care institution is located in the urban area, or if the institution enjoys a franchise, the average cost will increase. Related to this study is to explore the corresponding compensation policies for family health care. For this reason, the primary issue of the controversy is that although further studies have gradually confirmed that the average cost is related to the disease composition of the family health care institutions, people still cannot clearly conclude that many nursing homes are being As compensation, to adjust the compensation rate formed by different diseases. Therefore, when formulating policies, the government must take into account the fundamental differences between family health care facilities and nursing homes, taking into account the respective medical markets of both parties. Otherwise, it will affect the effectiveness of policy implementation.