Leichter H M
Linfield College, USA.
J Health Polit Policy Law. 1999 Feb;24(1):147-60. doi: 10.1215/03616878-24-1-147.
In 1994 Oregon began rationing health care for its Medicaid population, offering health policy makers and analysts around the country a view of one alternative future for health care delivery. The question now, four years after the experiment began, is what does that future look like? The short answer is that it does not look all that different from the present, but it looks different enough to offer important lessons to other states and the federal government. The Oregon experiment, including the prioritization of services and the aggressive use of managed care, has facilitated the expansion of health care coverage to over 100,000 additional Oregonians, helped decrease the percentage of the uninsured as well as reduce uncompensated care in hospitals, reduced the use of hospital emergency rooms, and reduced cost shifting. By most measures, the Oregon experiment appears to be a success.
1994年,俄勒冈州开始对其医疗补助计划覆盖人群实行医疗配给制,为美国各地的医疗政策制定者和分析人士提供了一种未来医疗服务提供方式的参考。如今,在这项实验开始四年后,问题是那个未来会是什么样子呢?简短的回答是,它看起来与现在并没有太大不同,但又足够不同,能为其他州和联邦政府提供重要的经验教训。俄勒冈州的这项实验,包括服务优先级排序以及积极采用管理式医疗,推动了医疗覆盖范围扩大到额外的10万多名俄勒冈人,有助于降低未参保率以及减少医院的无偿医疗服务,减少了医院急诊室的使用,并减少了成本转嫁。从大多数指标来看,俄勒冈州的这项实验似乎是成功的。