Danis Marion, Biddle Andrea K, Goold Susan Dorr
Department of Clinical Bioethics, Warren G. Magnuson Clinical Center, National Institutes of Health, Bethesda, MD 20892-1156, USA.
Gerontologist. 2004 Feb;44(1):58-67. doi: 10.1093/geront/44.1.58.
The purpose of this study was to demonstrate the feasibility and results of ascertaining Medicare enrollees' priorities for insured medical benefits.
Structured group exercises were conducted with Medicare enrollees from clinical and community settings in central North Carolina. By participating in a decision exercise, CHAT: Choosing Healthplans All Together, individuals and groups chose medical benefits within the constraints of a monthly Medicare + Choice premium. The acceptability of the exercise and the resulting benefit package were assessed.
Ten groups (121 individuals) made trade-offs that involved the selection of more tightly managed care in order to add pharmacy, dental, and long-term care benefits. All were willing to forgo experimental therapy; 7 groups gave priority to insuring the uninsured. Participants found the exercise overwhelmingly acceptable and were willing to abide by their groups' choices.
Medicare enrollees are able to come to consensus about financially constrained benefit packages that may be useful in reform of the Medicare program.
本研究旨在证明确定医疗保险参保人对参保医疗福利的优先选择的可行性及结果。
对北卡罗来纳州中部临床和社区环境中的医疗保险参保人进行了结构化小组活动。通过参与一项决策活动“共同选择健康计划”（CHAT），个人和小组在每月医疗保险加选择计划保费的限制范围内选择医疗福利。评估了该活动及由此产生的福利套餐的可接受性。
十个小组（121人）进行了权衡，涉及选择管理更严格的医疗服务，以便增加药房、牙科和长期护理福利。所有人都愿意放弃实验性治疗；7个小组优先为未参保者提供保险。参与者发现该活动非常可接受，并愿意遵守小组的选择。
医疗保险参保人能够就可能对医疗保险计划改革有用的资金受限福利套餐达成共识。
