Studnicki J, Stevens C E, Knisely L
J Med Educ. 1985 Jun;60(6):454-60. doi: 10.1097/00001888-198506000-00004.
A cybernetic control program aimed at reducing inappropriate days of hospital stay for patients was implemented for all Medicare admissions at hospitals in four counties in Western Maryland. The findings of a study of the program are reported here. The objective of the study was to determine the relationship of the volume of the physician's hospitalized patients on both the existing levels of inappropriate hospital utilization and the physician's response to the cybernetic system. The findings indicated that: (a) existing levels of inappropriate hospital use generally increased with higher patient volume, (b) physicians with a low volume of hospitalized patients were less likely to decrease their inappropriate use of hospitals as a result of feedback than physicians with medium or high volumes of admitted patients, and (c) at all volume levels, the average decrease in inappropriate days was larger than the average increase in inappropriate days.
针对马里兰州西部四个县医院的所有医疗保险入院患者，实施了一项旨在减少患者不适当住院天数的控制论控制计划。本文报告了该计划的一项研究结果。该研究的目的是确定医生住院患者数量与不适当医院利用的现有水平以及医生对控制论系统的反应之间的关系。研究结果表明：(a) 不适当医院使用的现有水平通常随着患者数量的增加而增加；(b) 住院患者数量少的医生因反馈而减少不适当医院使用的可能性低于住院患者数量中等或较多的医生；(c) 在所有数量水平上，不适当天数的平均减少量大于不适当天数的平均增加量。
