Blomqvist A G
Department of Economics, University of Western Ontario, London, Canada.
Health Policy. 1992;21(2):113-27. doi: 10.1016/0168-8510(92)90012-z.
This article compares the organization of the Swedish health care system with that in three other countries, the U.S., the U.K., and Canada, focussing on three main areas: (1) the provision and financing (public or private) of health insurance, including the question of the quality of the insurance protection offered; (2) the organization of the production of health services, and the economic incentives on the system's decision-makers (doctors, hospital managers, politicians, etc.). Possible answers are suggested to the question why one country (the U.K.) is able to provide health care to its population at an average cost considerably below that of the others: Differences in the quality of the insurance protection and health services; in the incentives on the system managers to exercise cost control; and in the incentives on service providers such as physicians, to consider cost-effectiveness when making treatment decisions. An attempt is made to suggest lessons for health care reform in Sweden and elsewhere.
本文将瑞典医疗体系的组织架构与其他三个国家(美国、英国和加拿大)的进行比较,重点关注三个主要领域:(1)医疗保险的提供与融资(公共或私人),包括所提供保险保障的质量问题;(2)医疗服务生产的组织架构,以及该体系决策者(医生、医院管理人员、政治家等)面临的经济激励措施。针对为何一个国家(英国)能够以远低于其他国家的平均成本为其民众提供医疗保健这一问题,提出了可能的答案:保险保障和医疗服务质量的差异;体系管理者进行成本控制的激励措施差异;以及诸如医生等服务提供者在做出治疗决策时考虑成本效益的激励措施差异。本文尝试为瑞典及其他地区的医疗改革提供经验教训。