Polich C L, Iversen L H
Health Care Financ Rev. 1987 Fall;9(1):43-9.
This article explores the issue o whether state-administered nursing home preadmission screening (PAS) programs are an effective means of controlling the utilization of long-term care. It is suggested that, overall, PAS may be increasing rather than decreasing the use of long-term care. Utilization control through PAS may be ineffective because it occurs too late in the placement decision process, there are insufficient placement alternatives, assessment tools do not adequately identify who is at risk of institutionalization, and policymakers and program administrators may have conflicting goals. Recommendations for improving the screening process include, among others, that States more clearly define program goals and that screening be conducted within a managed-care system.
本文探讨了由政府管理的疗养院入院前筛查（PAS）项目是否是控制长期护理利用的有效手段这一问题。研究表明，总体而言，PAS可能会增加而非减少长期护理的使用。通过PAS进行利用控制可能无效，因为它在安置决策过程中发生得太晚，安置选择不足，评估工具不能充分识别有机构化风险的人群，而且政策制定者和项目管理者可能有相互冲突的目标。改善筛查过程的建议包括，除其他外，各州更明确地界定项目目标，并在管理式医疗系统内进行筛查。
