Wallner Paul E, Konski Andre
21st Century Oncology, Inc, Fort Myers, FL, USA.
Semin Radiat Oncol. 2008 Jul;18(3):194-200. doi: 10.1016/j.semradonc.2008.01.007.
As health care spending in the United States continues to increase at a pace significantly faster than that of other sectors of the economy, there seems to be greater interest and willingness to consider the root causes of the rise and to explore options for reform. Some of the reasons for cost escalation are associated with a growing and aging population that all too often makes inappropriate personal choices, but others are clearly attributable to growth in the cost of drugs, hospital and nursing home care, provider reimbursement, and durable medical equipment. Some health care economists have suggested that the rapid introduction of new technologies has also played a major role. Vendors understandably desire early market penetration of any new device or technology, but often this may be accomplished before significant evidence of benefit is available. Our current system of device approval unlinked to coverage and payment has produced further disruption in the system. The nature of the problem and consideration of various factors in the introduction, implementation, and evaluation of new technologies will be considered.
随着美国医疗保健支出持续以远超经济其他部门的速度增长，人们似乎对探讨支出增长的根本原因以及探索改革方案表现出了更大的兴趣和意愿。成本上升的部分原因与不断增长且老龄化的人口有关，这些人常常做出不恰当的个人选择，但其他原因显然可归因于药品、医院和疗养院护理、医疗服务提供者报销以及耐用医疗设备成本的增加。一些医疗保健经济学家认为，新技术的迅速引入也起到了主要作用。供应商渴望新设备或技术尽早打入市场，这是可以理解的，但往往在有充分的益处证据之前就实现了。我们目前将设备审批与保险范围和支付脱钩的制度在该体系中造成了进一步的混乱。本文将探讨问题的本质以及在新技术的引入、实施和评估过程中对各种因素的考量。
