Rodrigues J M
Department of Public Health and Medical Informatics, Faculté de Médecine, Université, France.
Aust Health Rev. 1999;22(2):39-52; discussion 53-5. doi: 10.1071/ah990039.
The unpredictable French health care reform of 1995-96 introduced casemix tools to fund French hospitals at a regional level. After two years (1997-98), health care authorities and hospitals are facing great inequities and inefficiencies (1 to 3) in 22 French regions. Only one region (Ile de France, Paris) is above the national casemix index mean, the Index Synthétique d' Activité, and very few are equal to this national mean. The dilemma for most of the 22 regions under this national mean, and within a region like Rhône-Alpes (Saint Etienne), with inequities from 1 to 2, is to decide whether the main goal of the new health care policy is to reduce inequities and inefficiencies.
1995 - 1996年法国进行了不可预测的医疗改革，引入了病例组合工具，以便在地区层面为法国医院提供资金。两年后（1997 - 1998年），法国22个地区的医疗当局和医院面临着严重的不公平和低效率问题（1至3）。只有一个地区（法兰西岛，即巴黎）高于全国病例组合指数均值——综合活动指数，只有极少数地区与全国均值持平。对于全国均值以下的22个地区中的大多数，以及像罗纳 - 阿尔卑斯大区（圣艾蒂安）这样不公平程度在1至2之间的地区来说，两难的是要决定新医疗政策的主要目标是否是减少不公平和低效率。
