Nihom J, Gillpatrick T R, Wood V R
Kaiser Permanente, Portland, OR 97210, USA.
J Ambul Care Mark. 1994;5(2):57-68. doi: 10.1300/j273v05n02_05.
Effective and efficient delivery of health care is one of the critical issues facing the nation today. Currently, nearly 13% of the nation's GDP in spent on Health Care. Perhaps one-half of the increase in health care costs have been linked to the acquisition of new medical technology. This paper examines some of the issues relating to the acquisition and dissemination of the use of medical technology by acute care and outpatient facilities and discusses the rationing of medical technology. The paper concludes by identifying some of the approaches to controlling health care costs through the rationing of technology that have been presented in the literature and outlines the evolving new paradigm that is being advanced to address the issues of cost containment and access to health care.
有效且高效地提供医疗保健是当今国家面临的关键问题之一。目前，国家近13%的国内生产总值用于医疗保健。医疗保健成本增加的大约一半与获取新医疗技术有关。本文探讨了急性护理和门诊设施在获取和传播医疗技术使用方面的一些问题，并讨论了医疗技术的配给。本文最后通过识别文献中提出的一些通过技术配给来控制医疗保健成本的方法，并概述了为解决成本控制和医疗保健可及性问题而正在推进的不断演变的新范式。
