Strayer F, Kisker C T, Fethke C
Pediatrics. 1980 Dec;66(6):907-11.
Costs of two alternative methods for obtaining comparable quality outpatient care for pediatric cancer patients were examined. Costs incurred in obtaining care from specialists, "specialist-management," were compared to costs incurred in obtaining "shared-management," care provided by specialists and primary physicians combined. Shared-management medical costs for outpatient care were 10% less than they would have been had the care been obtained from specialists. The nonmedical costs of transportation, parking, food away from home, and lost productivity or income were all less under the shared-management medical care delivery system than they would have been had specialist management been utilized. The total estimated cost differences between the alternative systems for the delivery of outpatient care ($2,191.34) represents for shared management a mean saving per patient of approximately 29% in direct out-of-pocket expenses and a 59% savings in the indirect costs of lost income or productivity. A total theoretical mean 41% saving per patient was shown to accrue through the use of shared management.
对为儿科癌症患者提供可比质量门诊护理的两种替代方法的成本进行了研究。将从专科医生处获得护理（“专科医生管理”）所产生的成本与获得“共同管理”（由专科医生和初级医生联合提供护理）所产生的成本进行了比较。门诊护理的共同管理医疗成本比从专科医生处获得护理的成本低10%。在共同管理的医疗服务提供系统下，交通、停车、外出就餐以及生产力或收入损失等非医疗成本均低于采用专科医生管理时的成本。两种门诊护理提供系统之间估计的总成本差异（2191.34美元）表明，对于共同管理而言，每位患者在直接自付费用方面平均节省约29%，在收入或生产力损失的间接成本方面节省59%。结果表明，通过使用共同管理，每位患者理论上平均可节省41%。
