Cuellar Alison Evans, Gertler Paul J
Department of Health Policy and Management, Mailman School of Public Health, Columbia University, New York City, USA.
Health Aff (Millwood). 2003 Nov-Dec;22(6):77-87. doi: 10.1377/hlthaff.22.6.77.
During the past decade the hospital industry has made profound organizational changes, including the extensive consolidation of hospitals through merger and the formation of hospital systems. Although the rate of hospital system acquisitions may be slowing, the local presence of hospital systems is growing. Locally concentrated systems have been formed by both for-profit and nonprofit hospitals. Researchers have tended to ignore acquisitions or have portrayed system formation as primarily an issue of hospital ownership conversion, thereby focusing on the expansion of national, for-profit systems. This has left a large gap in policymakers' understanding of how locally concentrated systems may affect patient care and competition.
在过去十年中，医院行业发生了深刻的组织变革，包括通过合并进行医院的广泛整合以及医院系统的形成。尽管医院系统收购的速度可能正在放缓，但医院系统在当地的影响力正在增强。营利性和非营利性医院都形成了在当地集中的系统。研究人员往往忽视收购，或者将系统形成主要描述为医院所有权转换的问题，从而将重点放在全国性营利性系统的扩张上。这使得政策制定者在理解当地集中的系统如何影响患者护理和竞争方面存在很大差距。
