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成本转嫁支付的“水力作用”:基础、历史及影响

The cost-shift payment 'hydraulic': foundation, history, and implications.

作者信息

Dobson Allen, Davanzo Joan, Sen Namrata

机构信息

Lewin Group, Falls Church, VA, USA.

出版信息

Health Aff (Millwood). 2006 Jan-Feb;25(1):22-33. doi: 10.1377/hlthaff.25.1.22.

Abstract

The cost-shift payment "hydraulic" is an integral component of the fragmented U.S. health care financing system. If private payers' acceptance of the cost-shifting burden were to erode, our system of health care financing could become unstable. This is especially true for the hospital industry. In this paper we provide a series of examples of cost shifting and a historical profile of the cost shift in the hospital industry since 1980, noting that cost-shifting pressures seem to fluctuate over time and across health care markets. Cost shifting need not be dollar per dollar, as hospitals can absorb some degree of cost-shifting pressure through increased efficiency and decreases in service provision.

摘要

成本转嫁支付“压力”是美国碎片化医疗融资体系的一个重要组成部分。如果私人支付方对成本转嫁负担的接受度下降,我们的医疗融资体系可能会变得不稳定。医院行业尤其如此。在本文中,我们提供了一系列成本转嫁的例子,以及自1980年以来医院行业成本转嫁的历史概况,指出成本转嫁压力似乎会随时间和医疗市场的变化而波动。成本转嫁不一定是等额的,因为医院可以通过提高效率和减少服务提供来承受一定程度的成本转嫁压力。

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