Greenwald H P, Woodward J M, Berg D H
Health Serv Res. 1979 Fall;14(3):207-19.
Cost containment and access to appropriate care are the two most frequently discussed issues in contemporary health policy. Conceiving of the health services available in specific regions as "packages" of diverse items, the authors of this article consider the economic trade-offs among the various resources needed for appropriate care. In the discussion that follows, we examine the trade-offs between two divergent offering of the health care system: high technology medicine and support services. Specifically, we examine several strategies designed to achieve an optimal mix of investments in CT scanners and transportation resources in the South Chicago region. Using linear programming as a method for examining these options, the authors found that 1) the proper location of CT scanners is as important for cost containment as optimal number, and 2) excess capacity in the utilization of a single resource--CT scanners--need not imply inefficiency in the overall delivery of the service. These findings help demonstrate the importance of viewing health care as a package of interrelated services, both for achieving cost containment and for providing access to appropriate care.
成本控制和获得适当的医疗服务是当代卫生政策中讨论最频繁的两个问题。本文作者将特定地区可获得的卫生服务视为各种不同项目的“组合”，探讨了适当医疗所需的各种资源之间的经济权衡。在接下来的讨论中，我们研究了医疗保健系统两种不同服务之间的权衡：高科技医疗和支持服务。具体而言，我们研究了几种旨在实现南芝加哥地区CT扫描仪和交通资源投资最佳组合的策略。作者使用线性规划作为研究这些选择的方法，发现：1）CT扫描仪的合理选址对于成本控制与最佳数量同样重要；2）单一资源（CT扫描仪）利用中的产能过剩并不一定意味着整体服务提供效率低下。这些发现有助于证明将医疗保健视为相互关联服务组合的重要性，这对于实现成本控制和提供适当的医疗服务都很重要。
