Gitch D W
Rev Infect Dis. 1986 May-Jun;8(3):494-8. doi: 10.1093/clinids/8.3.494.
Medicare's Prospective Payment System (PPS) and its Diagnostic Related Groups (DRG) have celebrated a second anniversary. There is little doubt that the momentum of change started by the prospective payment concept will be around for some time. The formula for success contains a new approach to the management of health care organizations, instilling new life into health care management, creating challenges of new relationships and roles for medical staff, and serving to reshape the organizational structure of health care providers. Medicare will not be the only benefactor of this new scheme as prepayment spreads to other payors and providers of health care. Health care organizations have an opportunity to be innovative. Success will depend on whether health care executives and physicians can change, whether the results are satisfactory to users and payors, and whether the right incentives are preserved. The practice of infectious disease can play a unique and beneficial role in the prevention and control of infections through cost-effective surveillance programs and in the development and management of the antibiotics formulary. The costs of care can be appropriately controlled under the fixed payment systems, and survival in the new environment, more assured.
医疗保险的预付款制度（PPS）及其诊断相关分组（DRG）迎来了两周年。毫无疑问，预付款概念引发的变革势头将持续一段时间。成功的秘诀在于对医疗保健组织管理采用新方法，为医疗保健管理注入新活力，给医务人员带来新关系和角色的挑战，并有助于重塑医疗保健提供者的组织结构。随着预付款制度推广至其他医疗保健支付方和提供者，医疗保险并非这一新方案的唯一受益者。医疗保健组织有机会进行创新。成功将取决于医疗保健管理人员和医生能否做出改变，结果是否令用户和支付方满意，以及是否保留了正确的激励措施。传染病防治工作可通过具有成本效益的监测项目，以及在抗生素处方集的制定和管理方面，在感染预防和控制中发挥独特而有益的作用。在固定支付系统下，医疗费用可得到适当控制，在新环境中的生存更有保障。
