Ziebarth Nicolas R
Department of Policy Analysis and Management (PAM), Cornell University, 106 Martha Van Rensselaer Hall, Ithaca, NY, 14850, USA,
Int J Health Care Finance Econ. 2014 Mar;14(1):41-67. doi: 10.1007/s10754-013-9138-1. Epub 2013 Dec 4.
This study empirically evaluates the effectiveness of different health care cost containment measures. The measures investigated were introduced in Germany in 1997 to reduce moral hazard and public health expenditures in the market for rehabilitation care. Of the analyzed measures, doubling the daily copayments was clearly the most effective cost containment measure, resulting in a reduction in utilization of about [Formula: see text] . Indirect measures such as allowing employers to cut federally mandated sick pay or paid vacation during inpatient post-acute care stays did not significantly reduce utilization. There is evidence neither for adverse health effects nor for substitution effects in terms of more doctor visits.
本研究实证评估了不同医疗成本控制措施的有效性。所调查的措施于1997年在德国推出,旨在降低康复护理市场中的道德风险和公共卫生支出。在分析的措施中,将每日自付费用加倍显然是最有效的成本控制措施,导致使用率降低了约[公式:见原文]。诸如允许雇主在急性后期住院护理期间削减联邦规定的病假工资或带薪休假等间接措施,并未显著降低使用率。没有证据表明存在对健康的不利影响,也没有证据表明在增加看诊次数方面存在替代效应。