Dartmouth Institute for Health Policy and Clinical Practice, Lebanon, NH, USA.
Health Aff (Millwood). 2010 May;29(5):991-7. doi: 10.1377/hlthaff.2009.0388.
The belief that integrated delivery systems offer better care at lower cost has contributed to growing interest in accountable care organizations. These provider-led delivery systems would accept responsibility for their primary care populations and would have financial incentives for improving care and reducing costs. We investigated this belief by comparing the costs and quality of care provided to Medicare beneficiaries in twenty-two health care markets by physicians who did and did not work within large multispecialty group practices affiliated with the Council of Accountable Physician Practices. In most markets, and after adjustment for patient factors, group physicians affiliated with the council provided higher-quality care at a 3.6 percent lower annual cost ($272 per patient).
人们相信一体化交付系统能够以更低的成本提供更好的医疗服务，这促使人们对责任医疗组织的兴趣日益浓厚。这些以提供商为主导的交付系统将对其初级保健人群负责，并将获得改善医疗服务和降低成本的经济激励。我们通过比较在 22 个医疗保健市场中，向 Medicare 受益人的医疗成本和服务质量，对这一观点进行了研究，这些市场中的医生分别就职于有责任医生协会附属的大型多专科团体实践和没有附属的医生。在大多数市场中，在调整了患者因素后，与协会有附属关系的团体医生的每年成本降低了 3.6%（每位患者 272 美元），但提供了更高质量的医疗服务。
