Rossignol C
Bull Acad Natl Med. 1990 Jun-Jul;174(6):719-29; discussion 729-30.
Since its creation, the Medical Service of Health Insurance has known an important evolution. Initially, its essential role was to control the allowances paid to the insured persons of the regimes of Health Insurance. Its aspect was rather coercive. But since 1960 a change has been outlined with the creation of the "Haut Comité Médical de la Sécurité Sociale": the Medical Control left its place to the Medical Service. With this denomination, its functions never stopped expanding. The Medical Service maintained its tasks of control devolved by the different regulations, and that is how it falls to it to express a view about long term diseases, disability occupational injuries, etc. It is also responsible for setting up "selective" controls with regard to some of medical or ancillary medical acts. But this taskwork is coupled with an important activity: the counsel. This responsibility is orientated in three directions: the Health Insurance Associations, the insured persons, and the Health Professions particularly as a part of the conventions binding them to the organizations of the French social protection system. During these last years new date intervened in health insurance matters in consequence of the economical crisis. Henceforward, it suits to find just a balance between a social protection of a high standard and adapted care of quality for the best cost. New opportunities are offered to the Medical Service to face this situation and gave it also a fresh impulse. This new evolution fits into an activity of public health considering the progress of the medicine. This activity must be orientated to a better knowledge of dispensed care and its good employment. Several orientations must be detained. In disease matters, informations in possession of the medical services are to be operated and, thanks to the data processing, a balance sheet of expenses will be drawn up, comparing them with diagnostic and therapeutic means. These studies, whose results will be published, must be guided with an exemplary scientific strictness and be supported by uncontested leading people in the medical world. Hospitalization is the other field where the role of the medical service must be essential. It certainly charges to continue the individual controls. But it must go further and be interested in the hospital working, as well as in the aggregate as by hospital service. This permits to get indispensable informations for useful decisions in view of a better hospitalisation.(ABSTRACT TRUNCATED AT 400 WORDS)
自成立以来，医疗保险医疗服务部门经历了重大演变。最初，其主要作用是控制支付给医疗保险制度参保人员的津贴。其工作方式颇具强制性。但自1960年随着“社会保障医疗高级委员会”的成立，情况开始发生变化：医疗监管被医疗服务所取代。以此为名，其职能不断扩展。医疗服务部门保留了不同法规赋予的监管任务，因此要对慢性病、残疾工伤等发表意见。它还负责对某些医疗或辅助医疗行为进行“选择性”监管。但这项任务工作还伴随着一项重要活动：提供咨询。这项职责主要面向三个方向：医疗保险协会、参保人员以及医疗行业，特别是作为将他们与法国社会保护体系组织联系起来的公约的一部分。在过去几年里，由于经济危机，医疗保险事务出现了新情况。从今往后，需要在高标准的社会保护和以最佳成本提供适配的优质护理之间找到平衡。医疗服务部门面临着应对这种情况的新机遇，这也给了它新的推动力。考虑到医学的进步，这种新的演变符合公共卫生活动的范畴。这项活动必须旨在更好地了解所提供的护理及其合理使用。必须把握几个方向。在疾病方面，要利用医疗服务部门掌握的信息，并通过数据处理，编制一份费用清单，将其与诊断和治疗手段进行比较。这些研究结果将会公布，必须以堪称典范的科学严谨性为指导，并得到医学界无可争议的权威人士的支持。住院治疗是医疗服务部门必须发挥关键作用的另一个领域。当然，它要继续进行个别监管。但它必须更进一步，关注医院的运作以及医院服务的整体情况。这有助于获取做出有用决策所需的必要信息，以实现更好的住院治疗。（摘要截选至400字）
