Norton E C
Department of Health Care Policy, Harvard Medical School, Boston, MA 02115.
J Health Econ. 1992 Aug;11(2):105-28. doi: 10.1016/0167-6296(92)90030-5.
A social experiment was conducted in San Diego to test the effectiveness of monetary incentives in improving the health of nursing home residents and lowering Medicaid expenditures. Use of a Markov model to represent the resulting health changes of nursing home residents shows that the monetary incentives had beneficial effects on both the quality and the cost of nursing home care. Moreover, the nursing homes admitted more people with severe disabilities, and the average length of their stays was shortened. If implemented, this kind of incentive program would save Medicaid substantial amounts of money, but not through lowering nursing home payments. Instead, the more efficient use of nursing homes would transfer more people out of hospitals and thereby save unnecessary hospital reimbursement.
在圣地亚哥进行了一项社会实验，以测试金钱激励措施在改善养老院居民健康状况和降低医疗补助支出方面的有效性。使用马尔可夫模型来表示养老院居民由此产生的健康变化，结果表明金钱激励措施对养老院护理的质量和成本都有有益影响。此外，养老院接收了更多重度残疾的人，并且他们的平均住院时间缩短了。如果实施这种激励计划，将为医疗补助节省大量资金，但不是通过降低养老院费用来实现。相反，更有效地利用养老院将使更多人从医院转出，从而节省不必要的医院报销费用。
