Doyle Y G, McNeilly R H
University of London.
Int J Technol Assess Health Care. 1999 Fall;15(4):619-28.
Eleven percent of the U.K. population holds private health care insurance, and 2.2 billion Pounds are spent annually in the acute sector of private health care. Although isolated from policy discussions about new medical technology in the National Health Service, the private sector encounters these interventions regularly. During 18 months in one company, a new medical technology was encountered on average every week; 59 leading edge technologies were submitted for authorization (18 on multiple occasions). There are certain constraints on purchasers of health care in the private sector in dealing with new technology; these include fragmentation of the sector, differing rationalities within companies about limitations on eligibility of new procedures while competing for business, the role and expertise of the medical adviser, and demands of articulate customers. A proactive approach by the private sector to these challenges is hampered by its independence. Poor communication between the public and private sectors, and the lack of a more inclusive approach to policy centrally, undermine the rational diffusion and use of new medical technology in the U.K. health care system.
英国11%的人口拥有私人医疗保险，每年在私人医疗保健的急性病治疗领域花费22亿英镑。尽管在关于国民医疗服务体系（NHS）新医疗技术的政策讨论中被孤立，但私营部门经常会遇到这些干预措施。在一家公司的18个月里，平均每周都会遇到一项新医疗技术；有59项前沿技术提交审批（其中18项多次提交）。私营部门的医疗保健购买者在应对新技术方面存在一定限制；这些限制包括该部门的碎片化、公司内部在争夺业务时对新程序资格限制的不同合理性、医学顾问的作用和专业知识，以及有表达能力的客户的需求。私营部门对这些挑战的积极应对因自身独立性而受阻。公共部门和私营部门之间沟通不畅，以及在政策制定上缺乏更具包容性的方法，破坏了新医疗技术在英国医疗保健系统中的合理推广和使用。
