Nelson B
Australian Medical Association, Barton.
Med J Aust. 1994 Sep 5;161(S1):S4-6.
The introduction of casemix payment systems into Australia's public hospitals is an inevitability which the Australian Medical Association has now begun to address. A greater involvement of clinicians in the design and implementation of casemix can add substantial quality to these systems. However, there is concern that a proliferation of separate casemix systems may be contrary to overall health policy developments and that governments will not understand the limits of casemix. Recent attempts to include medical payments within a casemix payment system in the private sector faced our united opposition. Finally, special care needs to be taken to ensure that the introduction of a casemix payment system does not further disadvantage access to high quality health care for Aborigines.
将病例组合支付系统引入澳大利亚公立医院是不可避免的,澳大利亚医学协会现已开始着手应对这一问题。临床医生更多地参与病例组合的设计和实施可以显著提升这些系统的质量。然而,有人担心单独的病例组合系统过多可能与整体卫生政策发展相悖,而且政府可能不理解病例组合的局限性。最近在私营部门将医疗支付纳入病例组合支付系统的尝试遭到了我们的一致反对。最后,需要特别注意确保病例组合支付系统的引入不会进一步使原住民获得高质量医疗服务的机会处于不利地位。