MacStravic R C
Health Prog. 1985 May;66(4):54-7.
Physicians' referring and admitting behavior as well as their clinical management practices are major determinants of hospitals' profitability under prospective payment. Four techniques are available to hospitals that seek to increase market share: Recruitment and retention strategies. In planning the mix of specialties represented on staff, hospitals should consider the effects of a physician's practice on the hospital's case mix. Peer pressure. Peer review programs in hospitals as well as through medical or specialty societies may help persuade physicians to alter their use of services. Education and information programs. Hospitals can assist physicians in patient management by conducting economic grand rounds, developing committees to study and communicate cost data to physicians, and providing information on alternatives to hospitalization. Incentives. Putting physicians at risk by linking planned expenditures to hospital financial performance can influence practice patterns. Other techniques include offering limited partnerships to medical staff members and merging the hospital and medical staff into one corporation. Hospitals may also need to influence physicians away from ventures that compete directly with the institution, such as ambulatory surgery centers.
在预期支付制度下,医生的转诊和收治行为以及他们的临床管理实践是医院盈利能力的主要决定因素。对于寻求增加市场份额的医院来说,有四种方法:招聘和留用策略。在规划员工所代表的专业组合时,医院应考虑医生的业务对医院病例组合的影响。同行压力。医院内部以及通过医学或专业协会开展的同行评审项目可能有助于说服医生改变服务使用方式。教育和信息项目。医院可以通过举办经济大查房、成立委员会研究成本数据并与医生沟通,以及提供住院替代方案的信息,来协助医生进行患者管理。激励措施。将计划支出与医院财务绩效挂钩,让医生承担风险,可以影响其执业模式。其他方法包括向医务人员提供有限合伙制,以及将医院和医务人员合并为一家公司。医院可能还需要引导医生远离与机构直接竞争的业务,如门诊手术中心。