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分析与评论：质量、数量和成本之间的权衡取舍：如果必须做出选择，该如何取舍。

Analysis & commentary: The trade-off among quality, quantity, and cost: how to make it--if we must.

机构信息

Department of Health Care Management, Wharton School, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

出版信息

Health Aff (Millwood). 2011 Apr;30(4):574-80. doi: 10.1377/hlthaff.2011.0081.

DOI:10.1377/hlthaff.2011.0081
PMID:21471475
Abstract

The Affordable Care Act, with its subsidies, demonstrations, commissions, and study groups, embodies a considerable amount of regulatory and policy pressure on markets to improve the quality of health care. However, it is possible that this government-led movement will lead to a lot of talk about quality but not necessarily much improvement. A better strategy may be found through "disruptive innovation," a market-driven approach that has balanced cost and quality in other industries. An example would be to provide lower-cost substitutes for some aspects of primary physician care, in the form of care at a retail clinic. Consumers might not perceive a clinic as a perfect substitute for physician care, but they might prefer the greater convenience and lower cost. Perhaps a little less quality for a lot less money might be acceptable to consumers and taxpayers, as we work to keep medical spending from siphoning off funds required for other needs.

摘要

平价医疗法案通过补贴、示范项目、委员会和研究小组等手段，对市场施加了相当大的监管和政策压力，以提高医疗保健的质量。然而，这种由政府主导的运动有可能导致大量关于质量的讨论，但不一定会有实质性的改善。通过“颠覆性创新”——一种在其他行业平衡成本和质量的市场驱动方法，可能会找到更好的策略。一个例子是，通过零售诊所为初级医生护理的某些方面提供低成本的替代方案。消费者可能不会将诊所视为医生护理的完美替代品，但他们可能更愿意选择更方便、成本更低的方式。在我们努力防止医疗支出挤占其他需求所需资金的过程中，对于消费者和纳税人来说，少一点质量、少花一点钱可能是可以接受的。

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Health Aff (Millwood). 2011 Apr;30(4):574-80. doi: 10.1377/hlthaff.2011.0081.
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8
Beyond the Affordable Care Act: achieving real improvements in Americans' health.超越平价医疗法案：实现美国人健康的真正改善。
Health Aff (Millwood). 2010 Aug;29(8):1481-8. doi: 10.1377/hlthaff.2010.0071.
9
Creating a framework for getting quality into the public health system.为公共卫生系统质量建设创造框架。
Health Aff (Millwood). 2011 Apr;30(4):737-45. doi: 10.1377/hlthaff.2011.0129.
10
Driving population health through accountable care organizations.通过责任医疗组织推动人口健康。
Health Aff (Millwood). 2011 Jan;30(1):41-50. doi: 10.1377/hlthaff.2010.0935.

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