Mallenby M L
College of Business Administration, Creighton University, Omaha, NE 68178.
J Health Care Poor Underserved. 1993;4(3):177-93. doi: 10.1353/hpu.2010.0388.
In this study, several alternatives for the provision of health care to the medically indigent of Nebraska were analyzed quantitatively and qualitatively. These alternatives were: expansion of county medical assistance programs, state-purchased health insurance policies, Medicaid expansion, revenue pool to redistribute charity-care losses, all-payer rate system, mandated employer-purchased health insurance, and charity-care districts. Under four future scenarios, alternatives were ranked on the basis of program costs, a sensitivity analysis, and qualitative criteria. This analysis found that state-purchased health policies would result in lower program costs than either an increase in county assistance programs or employer-mandated health insurance. Medicaid expansion would reach fewer than one-third of the state's medically indigent. A revenue pool and all-payer rate system are the least costly alternatives but depend on the continuing good will of providers.
在本研究中,对向内布拉斯加州医疗贫困人群提供医疗保健的几种方案进行了定量和定性分析。这些方案包括:扩大县医疗救助计划、州购买的健康保险政策、医疗补助扩大计划、重新分配慈善医疗损失的收入池、全支付者费率系统、强制雇主购买健康保险以及慈善医疗区。在四种未来情景下,根据项目成本、敏感性分析和定性标准对这些方案进行了排名。该分析发现,州购买的健康保险政策导致的项目成本将低于县救助计划的增加或雇主强制购买的健康保险。医疗补助扩大计划覆盖的州医疗贫困人群不到三分之一。收入池和全支付者费率系统是成本最低的方案,但依赖于提供者持续的善意。