Cohen A B, Rock R C
J Health Care Technol. 1985 Spring;1(4):237-55.
Recent changes in Medicare financing policy and in state certificate of need (CON) policies have greatly altered the environment in which hospitals and physicians must operate. These policy changes likely will influence the development, adoption, and use of new technologies, including those employed in clinical laboratories. Some hospitals, particularly large academic health centers, are responding to the new incentives under Medicare prospective payment by (1) implementing integrated case mix and financial information systems, (2) monitoring and evaluating physician practice patterns, (3) improving the quality of analyses underlying their technology acquisition decisions, and (4) striving toward improved relations with medical staff. Clinical laboratories are also responding to these financial pressures through (1) more cautious adoption of new technologies, (2) selective automation of tests that reduce direct costs, (3) more prudent "make-or-buy" decisions regarding test performance sites, and (4) focused effort to improve turnaround times for inpatient testing and reporting.
医疗保险融资政策和州医疗需求证书（CON）政策最近的变化极大地改变了医院和医生必须运营的环境。这些政策变化可能会影响新技术的开发、采用和使用，包括临床实验室中使用的技术。一些医院，特别是大型学术健康中心，正在通过以下方式应对医疗保险预期支付下的新激励措施：（1）实施综合病例组合和财务信息系统；（2）监测和评估医生的执业模式；（3）提高其技术采购决策所依据分析的质量；（4）努力改善与医务人员的关系。临床实验室也在通过以下方式应对这些财务压力：（1）更谨慎地采用新技术；（2）对降低直接成本的检测进行选择性自动化；（3）对检测执行地点做出更审慎的“自制或外购”决策；（4）集中精力缩短住院检测和报告的周转时间。
