Sterns Jay B
Goldman, Sachs & Co Chicahgo, USA.
J Health Care Finance. 2007 Fall;34(1):100-7.
Physicians and their practice patterns are the largest single determinant of the level of aggregate national health care expenditures. Integrated delivery systems (organizations linking a multispecialty physician groups and acute care hospitals) appear to be more efficient than other organizational structures while providing better clinical outcomes. To determine whether a subset of hospitals was more or less efficient than the national average, we relied on data from the Dartmouth Atlas Project, which included data from 4,346 hospitals. The analysis was restricted to patients who had one or more of 12 chronic illnesses associated with a high probability of death, and the number of hospitals identified as our control group was 14, represented by 13 organizations. Based on the preliminary data, physicians operating in a multispecialty group appear to use less physician resources to care for their patients and admit less often to a hospital, thereby reducing health care expenditures. As the federal government seeks to foster more efficient health care delivery and better outcomes, it may look to the physician-led integrated delivery network as an example of an efficient and high quality model.
医生及其执业模式是全国医疗保健总支出水平的最大单一决定因素。整合式医疗服务体系（将多专科医生团队与急症医院联系起来的组织）在提供更好临床结果的同时，似乎比其他组织结构更有效率。为了确定一部分医院的效率是高于还是低于全国平均水平，我们依据了达特茅斯地图集项目的数据，该项目包含了4346家医院的数据。分析仅限于患有12种与高死亡概率相关的慢性疾病中的一种或多种的患者，被确定为我们对照组的医院数量为14家，由13个组织代表。根据初步数据，在多专科团队中执业的医生似乎在照顾患者时使用的医生资源较少，住院频率也较低，从而降低了医疗保健支出。随着联邦政府寻求促进更高效的医疗服务提供和更好的结果，它可能会将以医生为主导的整合式医疗服务网络视为高效和高质量模式的典范。
