Wyman M, Feeley J, Brimacombe G, Doucette K
Department of Family and Community Medicine, University of Toronto, Ont.
CMAJ. 1995 May 15;152(10):1601-4.
This article reviews the economic dimensions of the CMA's decision-making framework on core and comprehensive services. The framework was developed in a policy context characterized by three government objectives: reduction, reallocation and reassignment of health care resources. One economic-evaluation tool for the determination of core services is cost-effectiveness analysis. Some of the critical demand-side and supply-side considerations include the perceived value of medical services, the availability of private insurance and the supply of health care providers. The article concludes that shifting services to the private sector should not be viewed as a panacea for reducing the costs and improving the economic efficiency of the health care system, or for increasing patient access to, or the cost-effectiveness of high-quality care.
本文回顾了加拿大医学协会（CMA）关于核心服务和综合服务决策框架的经济层面。该框架是在以政府三个目标为特征的政策背景下制定的：医疗保健资源的削减、重新分配和重新安排。确定核心服务的一种经济评估工具是成本效益分析。一些关键的需求方和供给方考虑因素包括医疗服务的感知价值、私人保险的可获得性以及医疗保健提供者的供给。文章得出结论，将服务转移到私营部门不应被视为降低成本、提高医疗保健系统经济效率、增加患者获得高质量医疗服务的机会或提高其成本效益的万灵药。
