Rotman School of Management, University of Toronto, Ontario.
Health Aff (Millwood). 2013 Apr;32(4):643-52. doi: 10.1377/hlthaff.2012.1252.
Around the world, rising health care costs are claiming a larger share of national budgets. This article reviews strategies developed to contain costs in health systems in Canada, England, France, and Germany in 2000-10. We used a comprehensive analysis of health systems and reforms in each country, compiled by the European Observatory on Health Systems and Policies. These countries rely on a number of budget and price-setting mechanisms to contain health care costs. Our review revealed trends in all four countries toward more use of technology assessments and payment based on diagnosis-related groups and the value of products or services. These policies may result in a more efficient use of health care resources, but we argue that they need to be combined with volume and price controls--measures unlikely to be adopted in the United States--if they are also to meet cost containment goals.
在全球范围内，不断上涨的医疗保健成本正在占据国家预算的更大份额。本文回顾了 2000-2010 年期间加拿大、英国、法国和德国为控制医疗体系成本而制定的策略。我们使用了欧洲卫生系统和政策观察站（European Observatory on Health Systems and Policies）编制的关于每个国家卫生系统和改革的综合分析。这些国家依赖于一系列预算和价格设定机制来控制医疗保健成本。我们的审查揭示了这四个国家在更多地使用技术评估以及基于诊断相关组和产品或服务价值的支付方式方面的趋势。这些政策可能会导致更有效地利用医疗保健资源，但我们认为，如果这些政策也要达到控制成本的目标，那么还需要结合数量和价格控制——这在美国是不太可能采取的措施。
