McLaughlin C P, Ricketts T C, Freund D A, Sheps C G
Am J Public Health. 1985 Jul;75(7):749-53. doi: 10.2105/ajph.75.7.749.
Subsidized rural clinics and providers have long depended on the rural hospital for the care of some of their patients; the hospital has also been a source of revenue for these providers and programs. We studied a representative national sample of 116 subsidized rural clinics, focusing on the impact on rural clinic costs and revenues of the use of the hospital by the clinics' providers. Both clinic costs and revenue are reduced by the use of the hospital by rural practice providers, but costs are lowered to a greater extent than revenues, thereby enhancing the financial self-sufficiency of the subsidized clinic. The cost savings affect all aspects of clinic operation, but especially laboratory costs, community services costs, and administrative costs. The dependence of these rural clinics on the hospital indicates that the condition of subsidized rural clinics would be worsened by decreased availability of hospital services.
长期以来，获得补贴的农村诊所及医疗服务提供者一直依赖农村医院来照料其部分患者；医院也是这些医疗服务提供者和项目的收入来源。我们对116家获得补贴的农村诊所进行了具有代表性的全国抽样研究，重点关注诊所医疗服务提供者利用医院服务对农村诊所成本和收入的影响。农村医疗服务提供者利用医院服务会降低诊所的成本和收入，但成本降低的幅度大于收入降低的幅度，从而提高了获得补贴诊所的财务自给能力。成本节约影响诊所运营的各个方面，尤其是实验室成本、社区服务成本和行政成本。这些农村诊所对医院的依赖表明，医院服务可及性降低会使获得补贴的农村诊所状况恶化。
