Schlesinger M
Milbank Q. 1986;64(2):189-215.
Health Maintenance Organizations have become a favored vehicle for reform of the American health care system, while controlling costs and assuring quality. But for populations with a high prevalence of chronic disease--the elderly or the mentally ill--HMOs may fall short of meeting needs. Three stages of reform are proposed for adapting the principle of prepayment to better serve enrollees with chronic illness.
健康维护组织已成为美国医疗保健系统改革的首选工具，既能控制成本又能确保质量。但对于慢性病高发人群——老年人或精神病患者——健康维护组织可能无法满足其需求。为使预付原则更好地服务慢性病参保者，提出了三个改革阶段。
