Waitzkin H
Department of Medicine and School of Social Sciences, University of California-Irvine.
Am J Public Health. 1994 Mar;84(3):482-9. doi: 10.2105/ajph.84.3.482-a.
Managed competition remains untested as the basis of a national health program. However, key principles of managed competition first emerged in the military. For this study, published works on systems analysis and the planning-programming-budgeting system (PPBS), developed by Alain Enthoven and colleagues at the US Department of Defense during the 1960s, were compared with published presentations of managed competition. The influence of PPBS waned after it generated controversy and opposition. PPBS and managed competition represent similar managerial strategies of policy reform. Although the origin of managed competition in failed military policy does not ensure failure in the medical arena, this history also does not augur success.
作为国家卫生计划的基础，管理式竞争仍未得到检验。然而，管理式竞争的关键原则最早出现在军事领域。在本研究中，将20世纪60年代美国国防部的阿兰·恩托芬及其同事开发的系统分析和规划、计划与预算系统（PPBS）的已发表著作与管理式竞争的已发表论述进行了比较。PPBS在引发争议和反对后影响力减弱。PPBS和管理式竞争代表了类似的政策改革管理策略。尽管管理式竞争起源于失败的军事政策并不意味着在医疗领域也会失败，但这段历史也并非预示着成功。
