O'Connor K
Contultants Medical Group Inc., Oakland, CA 94609, USA.
Med Group Manage J. 1995 Nov-Dec;42(6):52-4, 56, 75.
A key concern for medical groups is how to manage information in a dual environment of capitation and fee for service. Information systems that work for one may not work for the other. Finding a system that works for both is critical. Some of the data that would be beneficial to collect for starting managing capitation contracts include: age/sex ratios of the practice patient population, average number of visits per patient per year, average number of visits by ICD-9 code for total population, average procedures per patient per year, and analysis of paverage payment per visit/procedure for commercial and Medicare patients. Some of the major concerns addressed include operational issues, financial viability and automated billing systems.
医疗集团面临的一个关键问题是如何在按人头付费和按服务收费的双重环境中管理信息。适用于一种模式的信息系统可能不适用于另一种。找到一个适用于两者的系统至关重要。一些对于开始管理按人头付费合同有益的数据收集包括：执业患者群体的年龄/性别比例、每位患者每年的平均就诊次数、按国际疾病分类第九版（ICD-9）编码统计的总人口平均就诊次数、每位患者每年的平均手术次数，以及商业保险和医疗保险患者每次就诊/手术的平均支付分析。所涉及的一些主要问题包括运营问题、财务可行性和自动计费系统。
