Stuart M E
Policy and Health Statistics Administration, Department of Health and Mental Hygiene, Baltimore, MD 21201.
Milbank Q. 1994;72(4):679-94.
The story of the development of the Maryland Medicaid Diabetes Care Program is narrated in this policy case study. Maryland Medicaid, a funding authority willing to assume a proactive role, decided to promote health care system changes expected to improve the health status of its recipients with diabetes. A state Medicaid budget crisis presented opportunities for financing new and expanded preventive services for those with this chronic disease. Specifically recounted is how Maryland Medicaid redefined its financing boundaries in an effort to overcome finance-induced fragmentation in diabetes health care delivery. The difficulties encountered by a single payer in moving unilaterally to alter health care practices are discussed. Two commentaries follow.
本政策案例研究讲述了马里兰州医疗补助糖尿病护理项目的发展历程。马里兰州医疗补助作为一个愿意发挥积极作用的资助机构，决定推动医疗保健系统变革，期望改善糖尿病患者的健康状况。该州医疗补助预算危机为为患有这种慢性病的人群提供新的和扩大的预防服务创造了融资机会。具体讲述了马里兰州医疗补助如何重新界定其融资范围，以努力克服糖尿病医疗服务中因融资导致的碎片化问题。还讨论了单一支付方在单方面改变医疗保健做法时遇到的困难。随后是两篇评论。
