Department of Health Policy and Management, Harvard University School of Public Health, Boston, Massachusetts, USA.
Health Aff (Millwood). 2009 Sep-Oct;28(5):1448-51. doi: 10.1377/hlthaff.28.5.1448.
Dartmouth researchers have demonstrated that there is tremendous geographic variation in the efficiency of health care delivery systems, fostered by perverse incentives that penalize integration, reward fragmentation, and encourage the use of technologies in the "gray areas" of medicine. This research suggests that it is possible to deliver higher-quality care at lower cost. We argue that integrated delivery systems, bundled payments, and more sophisticated comparative effectiveness analysis, rather than crude across-the-board cuts in payments, are the keys to stemming cost growth, improving value, and raising the trillion dollars needed to cover the uninsured.
达特茅斯研究人员表明，医疗服务提供系统的效率在地理上存在巨大差异，这是由扭曲的激励机制造成的，这些激励机制惩罚整合，奖励碎片化，并鼓励在医学的“灰色地带”使用技术。这项研究表明，以更低的成本提供更高质量的医疗服务是有可能的。我们认为，整合型服务提供系统、捆绑支付以及更复杂的相对效果分析，而不是一刀切地削减支付，是控制成本增长、提高价值和筹集覆盖未保险人群所需的万亿美元的关键。
