Christianson J B, Moscovice I S, Wellever A L, Wingert T D
School of Public Health, University of Minnesota, Minneapolis 55455.
Health Care Financ Rev. 1990 Spring;11(3):87-97.
An important aspect of the ongoing debate on rural health policy is how to deliver inpatient care in sparsely populated rural areas. One alternative is to create a new classification of rural inpatient facility that would deliver more limited services than available in a rural hospital, have more flexibility in staffing requirements, and possibly be reimbursed differently. The support of the Health Care Financing Administration for the concept of a limited service rural hospital is critical, since such a facility would not be financially viable without Medicare payment. Several organizational and public policy issues that merit consideration in the design and implementation of institutional alternatives to rural hospitals are discussed, including licensure and certification, scope of services, personnel, quality assurance, and payment.
当前农村卫生政策辩论的一个重要方面是如何在人口稀少的农村地区提供住院护理。一种选择是创建一种新的农村住院设施分类，这种设施提供的服务比农村医院的服务更有限，在人员配备要求上更灵活，并且可能获得不同的报销方式。医疗保健财务管理局对有限服务农村医院概念的支持至关重要，因为没有医疗保险支付，这样的设施在财务上是不可行的。本文讨论了在设计和实施农村医院替代机构时值得考虑的几个组织和公共政策问题，包括许可和认证、服务范围、人员、质量保证和支付。
