Broyles R W
College of Health Related Professions, Medical University of South Carolina, Charleston 29425-2701.
Inquiry. 1990 Spring;27(1):86-96.
Focusing on two prospective payment systems that operated concurrently in New Jersey, this study employs the hospital department as the unit of analysis and compares the effects of the all-payer DRG system with those of the SHARE program on hospitals. Relative to the SHARE program, which regulated the revenue derived from Blue Cross and Medicaid, the results indicate that the comprehensive approach to prospective payment induced hospitals to control not only the direct costs of multiple dimensions of patient care per case but also the direct cost per day of nursing care and per unit of ancillary care. The results also suggest that the DRG system reduced the length of stay, the daily use of radiological procedures, and the volume of these services per case. On the other hand, the DRG system was accompanied by an increase in the daily use of laboratory procedures and the volume of laboratory care per case.
本研究聚焦于新泽西州同时运行的两种前瞻性支付系统，以医院科室作为分析单位，比较了全付费诊断相关分组（DRG）系统与共享计划（SHARE）对医院的影响。相对于规范来自蓝十字医保和医疗补助收入的共享计划，结果表明，前瞻性支付的综合方法促使医院不仅控制每个病例患者护理多维度的直接成本，还控制护理每日直接成本和每单位辅助护理成本。结果还表明，DRG系统缩短了住院时间，减少了每日放射检查程序的使用以及每个病例这些服务的量。另一方面，DRG系统伴随着每日实验室检查程序使用的增加以及每个病例实验室护理量的增加。
