McGuire T G
Inquiry. 1989 Summer;26(2):292-303.
Public and private payers can set the terms of demand-side cost sharing in insurance for patients and supply-side cost sharing in the form of reimbursement for providers. This paper summarizes a model in which health care utilization is affected by both demand- and supply-side cost sharing. The combined effects of these two policies are simulated in an application to inpatient mental health care. Because supply-side cost sharing (as would take place in a prospective payment system) limits cost without imposing financial risk on patients, it is preferred as a policy for restraining cost. I show in the case studied that when supply-side cost sharing is introduced, insurance coverage should improve.
公共和私人支付方可以设定患者保险中需求方成本分担的条款,以及以提供者报销形式的供给方成本分担。本文总结了一个模型,其中医疗保健利用受到需求方和供给方成本分担的影响。在住院精神卫生保健的应用中模拟了这两项政策的综合效果。由于供给方成本分担(如在预期支付系统中那样)在不给患者带来财务风险的情况下限制了成本,因此作为一种成本控制政策更受青睐。我在所研究的案例中表明,当引入供给方成本分担时,保险覆盖范围应该会得到改善。