Mulhearn J, Eurenius K
JAMA. 1979 Sep 21;242(12):1285-7. doi: 10.1001/jama.242.12.1285.
The Veterans Administration's (VA) Department of Medicine and Surgery, the largest of the civilian federal health care systems, is under continuous White House, congressional, and public pressure to provide greater accountability and increased cost-effectiveness for its $5 billion-plus annual budget. Responding to these pressures, the VA is evaluating in ten of its 172 medical centers a new system of resource allocation and financial management known as a multilevel care system. This is a major VA intiative with highly important implications for both the VA and the private health care sector.
退伍军人事务部（VA）的医学与外科学部是联邦民用医疗保健系统中规模最大的部门，在白宫、国会和公众的持续压力下，要为其每年超过50亿美元的预算承担更大的责任并提高成本效益。为应对这些压力，VA正在其172家医疗中心中的10家评估一种新的资源分配和财务管理系统，即多级护理系统。这是VA的一项重大举措，对VA和私营医疗保健部门都具有极其重要的意义。
