Newman J F, Dunbar D M
Institute of Health Administration, J. Mack Robinson College of Business, Georgia State University, Atlanta, Georgia, USA.
Manag Care Q. 2000 Autumn;8(4):20-32.
Managed care systems achieve efficiencies by rationing the resources used to deliver care. This rationing has led to widespread perceptions of patient abuse and neglect in the form of restricted access to care, denial of choice, and overall reduction in the quality of care delivered. Conflicts of interest and fundamental ethical principles are perceived as often compromised in the managed care environment. We argue that ethical issues are inherent in managed care and cannot be avoided. Recently, federal and state governments have passed legislation and regulations to deal with the issue.
管理式医疗系统通过对提供医疗服务所使用的资源进行配给来实现效率提升。这种配给导致了人们普遍认为存在以限制就医机会、剥夺选择权以及整体降低所提供医疗服务质量等形式出现的患者虐待和忽视现象。在管理式医疗环境中，利益冲突和基本伦理原则常常被认为受到了损害。我们认为伦理问题在管理式医疗中是固有的，无法避免。最近，联邦和州政府已经通过了法律法规来处理这个问题。
