Ransom S B
Wayne State University School of Medicine, MI, USA.
Physician Exec. 1998 May-Jun;24(3):38-41.
Capitation contracts require health care organizations to negotiate on a much more sophisticated and risky level. Understanding whether a capitation contract will allow a hospital to remain financially viable while providing quality care requires estimating the number of patients to be served, the amount and types of services to be offered, and the cost to provide them. This article presents an information system model designed to assist a large hospital, not only in determining true patient cost, but also in aggregating the cost information in different ways, such as conducting a case-mix analysis, to perform a more informed quote analysis for capitated contracts.
按人头付费合同要求医疗保健机构在一个更加复杂且风险更高的层面上进行谈判。要了解一份按人头付费合同是否能让医院在提供优质护理的同时保持财务上的可行性，就需要估算将要服务的患者数量、提供的服务数量和类型以及提供这些服务的成本。本文提出了一个信息系统模型，旨在帮助大型医院，不仅能确定真正的患者成本，还能以不同方式汇总成本信息，比如进行病例组合分析，以便对按人头付费合同进行更明智的报价分析。
