Goody B
Office of Research, Health Care Financing Administration, Baltimore, MD 21207.
Inquiry. 1993 Spring;30(1):34-40.
This study examines the possibility of developing alternative targeting criteria for identifying small rural hospitals that serve as the sole providers of hospital care in their market areas. Compared to facilities currently targeted under Medicare payment policies, high market share hospitals are larger, less isolated facilities that deliver more complex care to their patients than other rural hospitals. They do not appear to serve vulnerable patient populations. Most importantly, these facilities appear to be financially viable and are likely to continue to provide services to their patients. The results of the study suggest that appropriate targeting criteria for identifying essential access facilities for reimbursement policy should focus on both structural characteristics and utilization patterns.
本研究探讨了制定替代目标标准的可能性，以识别那些在其市场区域内作为医院护理唯一提供者的小型农村医院。与目前医疗保险支付政策所针对的机构相比，高市场份额的医院规模更大，所处位置不那么偏远，比其他农村医院为患者提供更复杂的护理。它们似乎并不服务于弱势患者群体。最重要的是，这些机构在财务上似乎是可行的，并且很可能会继续为其患者提供服务。该研究结果表明，用于确定报销政策所需基本准入机构的适当目标标准应同时关注结构特征和使用模式。
