Feder J, Scanlon W
Milbank Mem Fund Q Health Soc. 1980 Winter;58(1):54-88.
Federal and state regulation of capital expenditures has been advanced as a means both to ensure rational allocation of resources and to control costs. But evidence drawn from eight states suggests that limiting the supply of nursing home beds ("certificate of need"), without refining conflicting standards of eligibility, quality control, and reimbursement policies (Medicaid and "rate-setting"), effectively discriminates against persons most in need of medical care. Alternative strategies for achieving economy, equity, and efficiency are explored.
联邦政府和州政府对资本支出的监管，被视为一种确保资源合理分配和控制成本的手段。但来自八个州的证据表明，在没有完善资格、质量控制和报销政策（医疗补助和“费率设定”）等相互冲突的标准的情况下，限制养老院床位供应（“需求证明”），实际上歧视了最需要医疗护理的人群。本文探讨了实现经济、公平和效率的替代策略。
