Milbank Memorial Fund, New York, NY 10011, USA.
Prev Chronic Dis. 2010 Sep;7(5):A99. Epub 2010 Aug 15.
International efforts to increase the quality and efficiency of health care services may be creating financial savings that can be used to improve population health. This article examines evidence that such savings (ie, a quality/efficiency or value dividend) are accruing and how they have been allocated and assesses the prospects for reallocating future savings to improve population health. Savings have resulted mainly from reducing the number of inappropriate or harmful interventions, managing care of people with chronic disease more effectively, and implementing health information technology. Savings to date have accrued to the revenues of public and private collective purchasers of care and large provider organizations, but none seem to have been reallocated to address other determinants of health. Furthermore, improved quality sometimes increases spending.
国际上提高医疗服务质量和效率的努力可能正在创造可用于改善人口健康的财务节省。本文研究了这些节省（即质量/效率或价值红利）正在累积的证据，以及它们是如何分配的，并评估了将未来节省重新分配用于改善人口健康的前景。节省主要来自减少不适当或有害的干预措施的数量，更有效地管理慢性病患者的护理，以及实施健康信息技术。迄今为止，节省已计入公共和私人集体医疗保健购买者和大型医疗机构的收入，但似乎没有重新分配用于解决其他健康决定因素。此外，提高质量有时会增加支出。
