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竞争法在医疗保健质量方面的作用。

Competition law's role in health care quality.

作者信息

Jacobi John V

机构信息

Health Law & Policy Program, Seton Hall University School of Law, USA.

出版信息

Ann Health Law. 2002;11:45-71, table of contents.

Abstract

Professor Jacobi's essay analyzes the various regulatory responses that are available to the government when crises in quality of care occur. These responses range from complete government involvement, i.e. "command and control" regulation, to a limited caretaker role in maximizing market forces. In responding to the recent IOM Report on human error in medical care, Professor Jacobi looks back to the 1986 IOM Report that revealed the crisis of care going on in nursing homes as well as the more recent controversy involving managed care. Following his analysis of the varied governmental approaches to these issues, Professor Jacobi concludes that both the unfettered use of command and control regulation and the more limited remedies of market maintenance are inadequate in the face of medical error. He argues instead that limited but forceful governmental regulation should be predicated on understanding the limitations of professionalism and market forces, in order to fully protect patients who are at risk.

摘要

雅可比教授的文章分析了在医疗质量出现危机时政府可采取的各种监管应对措施。这些应对措施范围广泛,从政府的全面介入,即“指令与控制”监管,到在最大限度发挥市场力量方面扮演有限的看守角色。在回应近期医学研究所(IOM)关于医疗中人为失误的报告时,雅可比教授回顾了1986年医学研究所的报告,该报告揭示了疗养院中存在的护理危机以及近期涉及管理式医疗的争议。在分析了政府针对这些问题的不同处理方式后,雅可比教授得出结论:在面对医疗失误时,不加限制地使用指令与控制监管以及市场维护方面较为有限的补救措施都是不够的。相反,他认为有限但有力的政府监管应以理解专业主义和市场力量的局限性为基础,以便充分保护处于风险中的患者。

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