Dixon J, Glennerster H
Health Services Research Unit, London School of Hygiene and Tropical Medicine.
BMJ. 1995 Sep 16;311(7007):727-30. doi: 10.1136/bmj.311.7007.727.
The general practice fundholding scheme was introduced four years ago. So far its impact has not been formally evaluated nationally, but review of published research shows some trends. Fundholding has curbed prescribing costs and given general practitioners greater power to lever improvements in hospital services--for example, reducing waiting times for hospital treatment--but fundholding practices may have received more money than non-fundholding practices. The impact of fundholding on transactions costs, equity, and quality of care (particularly for patients of non-fundholding general practitioners) is unknown. Research into costly reforms such as fundholding needs to be coordinated.
全科医疗基金持有计划于四年前推出。到目前为止,其影响尚未在全国范围内得到正式评估,但对已发表研究的回顾显示了一些趋势。基金持有抑制了处方成本,并赋予全科医生更大的权力来推动医院服务的改善——例如,减少住院治疗的等待时间——但实行基金持有的医疗机构可能比未实行的医疗机构获得了更多资金。基金持有对交易成本、公平性和医疗质量(特别是未实行基金持有的全科医生的患者)的影响尚不清楚。对诸如基金持有等成本高昂的改革的研究需要进行协调。