Maynard A
Health Policy. 1986;6(4):329-40. doi: 10.1016/0168-8510(86)90048-5.
In this article a short description is given of the national health services in the United Kingdom. It is observed that the ways of financing the services have changed only marginally over the decades. Furthermore, it is pointed out that not much is really known about the efficiency of health care provision in the NHS. It is clear, however, that there are many adverse incentives in financing and payment arrangements. A number of recent innovations to overcome the observed problems are being discussed as well as a number of ideas to change organisational structures and incentive systems. One of the more promising ways seems to be to reorganise buying power of the financing agencies within the NHS and use this to countervail the power of providers.
本文简要介绍了英国的国民医疗服务体系。可以看到,几十年来该服务的融资方式仅略有变化。此外,还指出对于国民医疗服务体系中医疗保健提供的效率,人们实际上了解得并不多。然而,很明显,在融资和支付安排方面存在许多负面激励因素。文中讨论了一些近期为克服所观察到的问题而进行的创新举措,以及一些关于改变组织结构和激励体系的想法。其中一个比较有前景的方法似乎是重新组织国民医疗服务体系内融资机构的购买力,并利用这一点来抗衡供应商的权力。