Rosenstein A H
Children's Hospital of San Francisco.
Rev Fed Am Health Syst. 1990 Nov-Dec;23(6):19-21.
In the July/August 1990 issue of FAHS Review, a feature article focused on the new strategies needed for managing hospitals in the '90s. Suffering from the combined punch of restricted utilization and reduced reimbursements, hospitals can't help but feel the financial crunch created by these predicaments. Strategies for economic survival have included trying to maximize revenues by either increasing volume or reducing unnecessary expenses. But increasing price through rate increases or cost-shifting has limited potential in today's medical market. Increasing volume via participation in managed care programs is a risky maneuver at best, based on the extent of the volume-discount trade-off. Limiting expenses traditionally has been accomplished by following sound business cost-containment techniques, maximizing FTEs and productivity, improving staffing patterns at all levels of the organization, and eliminating non-profitable services. But there is one additional item that should be taken into consideration--the need to reduce expenses by improving efficiency in medical operations.
在1990年7/8月期的《FAHS评论》中，一篇专题文章聚焦于90年代管理医院所需的新策略。医院因利用率受限和报销减少的双重冲击而苦不堪言，不可避免地感受到了这些困境所造成的财务危机。经济生存策略包括通过增加业务量或减少不必要的开支来努力实现收入最大化。但在当今医疗市场，通过提高费率或成本转嫁来提高价格的潜力有限。基于业务量与折扣之间的权衡程度，通过参与管理式医疗计划来增加业务量充其量是一种冒险的策略。传统上，限制开支是通过遵循合理的商业成本控制技术、最大化全时等效人员（FTEs）和生产率、改善组织各级的人员配置模式以及取消无利可图的服务来实现的。但还有一个额外的因素需要考虑——通过提高医疗运营效率来降低开支的必要性。
