Center for Studying Health System Change, Washington, DC, USA.
Health Aff (Millwood). 2012 Apr;31(4):827-35. doi: 10.1377/hlthaff.2011.1085.
The emphasis that hospitals place on cutting-edge technology and niche specialty services to attract physicians and patients has set the stage for health care's most recent competitive trend: an increased level of targeted, geographic service expansion to "capture" well-insured patients. We conducted interviews in twelve US communities in 2010 and found that many hospital systems--some with facilities in geographically undesirable areas--have expanded to compete for better-insured patients by building or buying facilities and physician practices in nearby, more affluent communities. Along with extending services to new markets, these hospital outposts often serve to pull well-insured patients to flagship facilities. The acceleration and expansion of such geographically competitive strategies by hospitals has implications for cost and access. Although payers and competitors contend such strategies will lead to higher costs, hospitals assert the expansions will increase efficiency, increase access, and improve the quality of care provided to patients.
医院对前沿技术和利基专业服务的重视，旨在吸引医生和患者，这为医疗保健领域的最新竞争趋势奠定了基础：即针对特定地区的服务范围扩大，以“吸引”保险程度高的患者。我们在 2010 年对美国的 12 个社区进行了访谈，发现许多医院系统——包括一些位于地理位置不佳地区的医院——已经通过在附近富裕社区建设或收购设施和医生诊所，来扩大规模以争夺保险程度更高的患者。这些医院的前沿服务不仅扩展到了新的市场，还经常吸引保险程度高的患者到旗舰店就诊。医院在地理上展开竞争的策略正在加速和扩大，这对成本和可及性都产生了影响。尽管支付方和竞争对手认为这些策略将导致成本上升，但医院坚称这些扩张将提高效率、增加可及性并改善患者的护理质量。
