Davidson S M
Med Care. 1977 Jun;15(6):515-25. doi: 10.1097/00005650-197706000-00008.
The Professional Standards Review Organizations (PSROs) mandated by the Social Security Act aim to monitor and control hospital utilization by publicly funded patients, particularly those whose care is paid for by Medicare and Medicaid. One question to ask is, if PSROs prove successful in reducing suspected overutilization by public patients, would the principal private third parties, Blue Cross and commericial insurance plans, benefit by applying those techniques to their patients, as well. Data are presented from the Chicago Hospital Discharge Study, which was conducted in February, 1970, before PSRO activities were undertaken. They show that average length of stay for Medicaid patients is not consistently different from that for patients who pay by other means. Therefore, it is argued that, if it proves successful as applied to Medicaid patients, private third parties might benefit by using the PSRO mechanism to try to monitor and control the stays of their patients, as well.
《社会保障法》授权成立的专业标准审查组织（PSROs）旨在监督和控制由公共资金资助的患者的医院医疗服务使用情况，特别是那些医疗费用由医疗保险和医疗补助支付的患者。一个值得探讨的问题是，如果事实证明PSROs在减少公共患者疑似过度医疗方面取得成功，那么主要的私营第三方，即蓝十字保险公司和商业保险计划，是否也能通过将这些方法应用于他们的患者而获益。文中呈现的数据来自1970年2月进行的芝加哥医院出院研究，该研究是在PSROs开展活动之前进行的。数据显示，医疗补助患者的平均住院时间与其他付费方式患者的平均住院时间并无持续差异。因此，有人认为，如果事实证明PSROs应用于医疗补助患者取得成功，私营第三方也可能通过使用PSRO机制来尝试监督和控制其患者的住院时间而获益。
