Fink E B
Hosp Community Psychiatry. 1982 Jan;33(1):38-41. doi: 10.1176/ps.33.1.38.
Despite the proven clinical effectiveness and cost-effectiveness of partial hospitals programs, any third-party insurers still refuse to offer coverage of their services. A number of clinical, administrative, and fiscal issues involving current partial hospital programming and the health care system in general have led to this difficulty. The author outlines these barriers, which include concerns about lack of cost accountability, lack of financial incentive to third parties, and lack of consumer interest, and makes specific recommendations on pursuing coverage of partial hospital programs. He urges a redefinition of the scope of partial hospital services and the development of detailed standards of treatment as prerequisites to pursuing third-party coverage.
尽管部分医院项目已被证明具有临床有效性和成本效益,但仍有任何第三方保险公司拒绝为其服务提供保险。一些涉及当前部分医院项目以及整个医疗保健系统的临床、行政和财政问题导致了这一困境。作者概述了这些障碍,包括对缺乏成本问责制的担忧、对第三方缺乏财务激励以及消费者缺乏兴趣,并就争取部分医院项目的保险覆盖范围提出了具体建议。他敦促重新界定部分医院服务的范围,并制定详细的治疗标准,作为争取第三方保险的先决条件。