Garrison L P
Project HOPE Center for Health Affairs, Chevy Chase, MD 20815.
Health Care Financ Rev Annu Suppl. 1991:13-20.
This article assesses the arguments and evidence concerning the likely effectiveness of four supply-side cost-containment measures. The health planning efforts of the 1970s, particularly certificate-of-need regulations, had very limited success in containing costs. The new and related tools of technology assessment and practice guidelines hold some promise for refining benefit packages, but they are inadequate for micromanaging complex medical practices. Payment policies, such as hospital ratesetting, have enjoyed some success in limiting hospital cost growth but are less effective at controlling total costs. None of these measures alone is likely to address fully the fundamental issues of equity and efficiency in health care resource allocation that underlie the problem of rising costs.
本文评估了有关四项供方成本控制措施可能有效性的论点和证据。20世纪70年代的卫生规划努力，尤其是需求证明法规，在控制成本方面取得的成功非常有限。技术评估和实践指南等新的相关工具在完善福利套餐方面有一定前景，但不足以对复杂的医疗实践进行微观管理。诸如医院费率设定等支付政策在限制医院成本增长方面取得了一些成功，但在控制总成本方面效果较差。这些措施单独一项都不太可能充分解决医疗资源分配中公平和效率的基本问题，而这些问题是成本上升问题的根源。
