Thomas F
Health Care Financ Rev. 1999 Summer;20(4):1-6.
The shift in the site of service delivery from inpatient and institutional to ambulatory and community settings has been prompted by concerns over cost and the prospect for improving the quality of life. In response to these concerns, Medicare has implemented several demonstrations that emphasize ambulatory and community-based services. In this issue, articles are presented on four demonstrations, which focus on the extent to which coordinated care models reduce health care costs, and the cost effectiveness and beneficiary outcomes of disease-specific programs. Two articles are included on home health. One examines home health care in relation to the other Medicare post-acute benefits, and the other focuses on the use of home health care in the treatment of end stage renal disease (ESRD). Finally, two articles report on Section 1915c Medicaid home and community-based waiver programs.
服务提供场所从住院和机构环境向门诊和社区环境的转变，是出于对成本的担忧以及改善生活质量的前景。为应对这些担忧，医疗保险已实施了多项强调门诊和社区服务的示范项目。在本期中，发表了关于四个示范项目的文章，这些项目关注协调护理模式在多大程度上降低医疗成本，以及特定疾病项目的成本效益和受益结果。其中有两篇关于家庭医疗的文章。一篇探讨家庭医疗与其他医疗保险急性后期福利的关系，另一篇关注家庭医疗在终末期肾病（ESRD）治疗中的应用。最后，有两篇文章报道了第1915c条医疗补助家庭和社区豁免项目。
