Doherty N, Horowitz P A, Crakes G
Med Care. 1980 Jan;18(1):96-109. doi: 10.1097/00005650-198001000-00007.
The Chattanooga Project was a publicly funded program providing dental care to indigent children by private practice and public fixed and mobile clinics. Previous studies of the project have shown that the cost of providing dental care in public practices was lower than in private practices, and that this difference was not attributable either to the social characteristics of the children nor to the type of care provided. This article analyzes potential economic causes of the cost differences arising from the input-output relationships in each mode. Because the number and frequency of service types and productivity rates differed among the modes, a standard service package was developed. Productivity and costs were recalculated on the basis of this standard set of services. The results were that with services and productivity held constant the differences between private and public costs increased. The implications are that resources in the private practices were earning significantly higher returns than those in the public practices, and that public practices can offer viable economic alternatives to private practices in the provision of dental care.
查塔努加项目是一个由公共资金资助的项目，通过私人诊所以及公共固定和流动诊所为贫困儿童提供牙科护理。此前对该项目的研究表明，在公共诊所提供牙科护理的成本低于私人诊所，而且这种差异既不能归因于儿童的社会特征，也不能归因于所提供护理的类型。本文分析了每种模式下投入产出关系所产生的成本差异的潜在经济原因。由于服务类型的数量和频率以及生产率在不同模式之间存在差异，因此制定了一个标准服务包。基于这套标准服务重新计算了生产率和成本。结果是，在服务和生产率保持不变的情况下，私人和公共成本之间的差异增大了。这意味着私人诊所的资源所获得的回报明显高于公共诊所，并且在提供牙科护理方面，公共诊所可以为私人诊所提供可行的经济替代方案。
