Dee-Kelly P A, Heller S, Sibley M
Visiting Nurse Service of New York, New York 10021.
Nurs Clin North Am. 1994 Sep;29(3):471-81.
It is clear, even in the future of health care reform, that home care is a growing component of the health care industry. For many years, fee for service was the model reimbursement method. Today we are in a changing health care system that requires a greater emphasis on home care cost containment. New methods of reimbursement are a part of the change. Progressive home care agencies see this as an opportunity to become leaders. This approach does not come without certain risks, however. In taking the risks, it is imperative to minimize the chances for problems, obstacles, and compromising the quality of patient care. It requires that the agency develop a strategy, set a course, and then devote the resources necessary to meet these challenges. Resources may mean investing in upgraded information systems, hiring clinical specialists to develop care plans and protocols, or developing in-house case management staff to allow the agency to monitor use and quality. One thing is clear--the old way of doing business, cost-based fee for service, has a limited life span, and agencies need to embrace these changes, not ignore them.
很明显，即便在医疗保健改革的未来，居家护理仍是医疗保健行业中不断发展的组成部分。多年来，按服务收费一直是报销模式。如今，我们正处于一个不断变化的医疗保健系统中，该系统要求更加注重居家护理成本控制。新的报销方法是这种变化的一部分。先进的居家护理机构将此视为成为领导者的契机。然而，这种方法并非没有一定风险。在承担这些风险时，必须将出现问题、障碍以及损害患者护理质量的可能性降至最低。这要求机构制定一项战略，确定方向，然后投入必要资源来应对这些挑战。资源可能意味着投资升级信息系统、聘请临床专家制定护理计划和方案，或者培养内部病例管理人员，以便机构能够监控使用情况和质量。有一点很明确——旧的经营方式，即基于成本的按服务收费，寿命有限，各机构需要接受这些变化，而不是忽视它们。
