Reilly P C, Reilly M C
Ann Intern Med. 1980 Jul;93(1):128-32. doi: 10.7326/0003-4819-93-1-128.
The cost of an average outpatient visit to a physician at a Veterans Administration hospital in 1976 was estimated from hospital records to have been $80.35 ($104.46 in 1979 dollars). When productivity was used to measure relative cost, cost per visit ranged from a low of $32.66 (1979: $42.46) for hypertension clinic to a high of $243.48 (1979; $316.52) for hematology clinic. The average patient was seen 12.6 times annually at a cost of $1012 (1979: $1315). The major cost category for a physician visit was salaries, with nonphysician salaries costing twice as much as physician salaries. The cost of medical equipment was minimal. The findings suggest that the outpatient bookkeeping system was inadequate for cost accounting, the cost per visit was expensive, there were an excessive number of visits, and problems in the institutional delivery system of ambulatory care lowered productivity of physicians.
根据医院记录估算，1976年退伍军人管理局医院门诊患者看一次医生的费用为80.35美元（按1979年美元计算为104.46美元）。若用生产率衡量相对成本，每次就诊成本从高血压诊所的低至32.66美元（1979年：42.46美元）到血液学诊所的高至243.48美元（1979年：316.52美元）不等。平均每位患者每年就诊12.6次，费用为1012美元（1979年：1315美元）。医生诊疗的主要成本类别是薪资，非医生薪资成本是医生薪资的两倍。医疗设备成本微乎其微。研究结果表明，门诊簿记系统不足以进行成本核算，每次就诊成本高昂，就诊次数过多，且门诊护理机构提供系统存在问题，降低了医生的生产率。
