Davis Karen, Schoen Cathy
Commonwealth Fund in New York City, USA.
Health Aff (Millwood). 2007 Nov-Dec;26(6):w664-6. doi: 10.1377/hlthaff.26.6.w664. Epub 2007 Sep 18.
State policy officials are focusing on improving health insurance coverage, but other important dimensions of performance, including quality and cost, are receiving less attention. This paper explores the implications of new data on state personal health spending, quality, and health system performance. Personal health spending is not related to mortality or quality, but Medicare spending is closely linked to preventable hospitalization. States need to link improved insurance coverage with policy strategies to improve quality and efficiency--such as requiring those covered to designate a medical home and changing payment methods to reward care coordination and more prudent stewardship of resources.
州政策官员正专注于提高医疗保险覆盖率，但绩效的其他重要方面，包括质量和成本，却受到较少关注。本文探讨了有关州个人医疗支出、质量和医疗系统绩效的新数据所带来的影响。个人医疗支出与死亡率或质量无关，但医疗保险支出与可预防的住院密切相关。各州需要将提高保险覆盖率与改善质量和效率的政策策略联系起来——比如要求参保者指定一个医疗之家，并改变支付方式以奖励医疗协调和更审慎的资源管理。
