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消费者驱动的医疗保健:来自瑞士的经验教训。

Consumer-driven health care: lessons from Switzerland.

作者信息

Herzlinger Regina E, Parsa-Parsi Ramin

机构信息

Nancy R. McPherson Professor of Business Administration, Harvard Business School, Soldier's Field Road, A3-3, Boston, MA 02163, USA.

出版信息

JAMA. 2004 Sep 8;292(10):1213-20. doi: 10.1001/jama.292.10.1213.

Abstract

Switzerland's consumer-driven health care system achieves universal insurance and high quality of care at significantly lower costs than the employer-based US system and without the constrained resources that can characterize government-controlled systems. Unlike other systems in which the choice and most of the funding for health insurance is provided by third parties, such as employers and governments, in the Swiss system, individuals are required to purchase their own health insurance. The positive results achieved by the Swiss system may be attributed to its consumer control, price transparency of the insurance plans, risk adjustment of insurers, and solidarity. However, the constraints the Swiss system places on hospitals and physicians and the paucity of provider quality information may unduly limit its impact. The Swiss health care system holds important lessons, including evidence about its feasibility and equity, for the United States, which is now embarking on its own consumer-driven health care system.

摘要

瑞士以消费者为驱动的医疗保健系统实现了全民保险和高质量的医疗服务,其成本显著低于美国以雇主为基础的医疗系统,而且不存在政府控制型系统可能出现的资源受限情况。与其他医疗保险选择和大部分资金由雇主和政府等第三方提供的系统不同,在瑞士的系统中,个人需要自行购买医疗保险。瑞士系统取得的积极成果可能归因于其消费者控制权、保险计划的价格透明度、保险公司的风险调整以及团结互助。然而,瑞士系统对医院和医生的限制以及医疗服务提供者质量信息的匮乏,可能会过度限制其影响力。瑞士医疗保健系统为美国提供了重要的经验教训,包括其可行性和公平性方面的证据,而美国目前正着手建立自己的以消费者为驱动的医疗保健系统。

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