Triki Noa, Pliskin Joseph S, Greenberg Dan
Department of Health Systems Management, Ben-Gurion University of the Negev.
Harefuah. 2010 Aug;149(8):524-8, 550.
Co-payment strategies are frequently used by health insurers as a measure of containing healthcare costs. However, co-payments may reduce the use of essential drugs in chronically-ill patients. Recently, value-based insurance designs, where co-payments rates are determined by the value of the treatment, have been introduced in the United States. This review summarizes the results of recent studies in the United States, suggesting that reducing co-payments for highly valued treatments and raising co-payments for less effective treatments can lead to better compliance and better outcomes, with the potential of reducing long-term costs. Further research is needed to examine the feasibility of this approach and the long-term impact on quality of care and treatment costs in other healthcare systems, including Israel.
共付策略经常被健康保险公司用作控制医疗成本的一种措施。然而，共付可能会减少慢性病患者基本药物的使用。最近，美国引入了基于价值的保险设计，即共付率由治疗价值决定。这篇综述总结了美国近期研究的结果，表明降低高价值治疗的共付额，提高低效治疗的共付额，可能会带来更好的依从性和更好的治疗效果，同时有可能降低长期成本。还需要进一步研究来检验这种方法在包括以色列在内的其他医疗系统中的可行性，以及对医疗质量和治疗成本的长期影响。
