Chodroff C H, Krivenko C
York Hospital Foundation, PA, USA.
Physician Exec. 1994 Nov;20(11):11-4.
Regardless of the specific outcome of the current health reform debate in Washington, it is likely that major changes to the health care system are in the offering. These changes, many of which are already in place or imminent in some locations, will have a major impact on the evolving relationships between physicians and hospitals. Most expect that these changes will accelerate the development of integrated health care delivery systems that will compete in the marketplace for a mixture of public and private health insurance dollars. In this system of "managed competition," health care dollars will flow to those systems that can ensure the best clinical outcomes while using the least economic resources. In this scenario, competing collaborative health networks that can manage the continuum of care will be central to the health care delivery system. The economic and political ties between physicians and hospitals will become more closely linked as government and private payers of health care services foster the development of these integrated, value-based health care delivery systems.
无论华盛顿当前医疗改革辩论的具体结果如何，医疗保健系统很可能会发生重大变革。这些变革中的许多已经在某些地方实施或即将实施，将对医生与医院之间不断演变的关系产生重大影响。大多数人预计，这些变革将加速综合医疗保健服务体系的发展，这些体系将在市场上争夺公共和私人医疗保险资金。在这种“管理式竞争”体系中，医疗保健资金将流向那些能够以最少的经济资源确保最佳临床结果的体系。在这种情况下，能够管理连续护理的竞争性协作医疗网络将成为医疗保健服务体系的核心。随着政府和医疗保健服务的私人支付方推动这些基于价值的综合医疗保健服务体系的发展，医生与医院之间的经济和政治联系将变得更加紧密。
