Turck M, Smith J
Am J Med. 1985 Jun 28;78(6B):23-8. doi: 10.1016/0002-9343(85)90359-6.
The health care industry in general and hospitals in particular face an uncertain future as the federal government moved with unusual speed to enact sweeping Medicare legislation. These changing patterns of reimbursement reverse key economic incentives by which hospitals have been driven since the federal program for the elderly began 18 years ago. "Reasonable" cost reimbursement has been replaced by a policy that requires Medicare to establish and fix prices in advance, on a cost-per-case basis, using as a measure 467 categories called "diagnosis-related groups." These changes will present new challenges for the health care industry and will need innovative approaches to meet them. The prospective pricing system attempts to reverse the escalation of health care costs. Under this system, hospitals can realize greater profits only by reducing costs, not by incurring them. The prospective payment system will have profound effects on the practice of infectious diseases, and the potential impact on hospitals, the pharmaceutical industry, physicians, and patients will have to be studied in detail.
随着联邦政府以不同寻常的速度迅速颁布全面的医疗保险立法，整个医疗保健行业，尤其是医院，面临着不确定的未来。这些不断变化的报销模式扭转了自18年前联邦老年人项目启动以来推动医院发展的关键经济激励措施。“合理”的成本报销已被一项政策所取代，该政策要求医疗保险按病例成本预先确定并固定价格，以467个被称为“诊断相关组”的类别作为衡量标准。这些变化将给医疗保健行业带来新的挑战，需要创新的方法来应对。前瞻性定价系统试图扭转医疗保健成本的上升。在这个系统下，医院只有通过降低成本而不是产生成本才能实现更大的利润。前瞻性支付系统将对传染病的治疗产生深远影响，对医院、制药行业、医生和患者的潜在影响必须进行详细研究。
