Weil T P
Bedford Health Associates, Inc., Asheville, NC, USA.
J Health Care Finance. 1996 Spring;22(3):62-74.
A fundamental choice many states now face when implementing their cost containment efforts for the health field is to weigh the extent to which they should rely on either competitive or regulatory strategies. To study the efficacy of America's current market-driven approaches to constrain health expenditures, an analysis was undertaken of 1993 hospital discharge costs and related data of the 15 states in the United States with the highest percent of health maintenance organization (HMO) market penetration. The study's major finding was that a facility operating with a lesser number of paid hours was more critical in reducing average expense per discharge than whether the hospital was located in a "competitive" or a "regulated" state. What is proposed herein to enhance hospital cost containment efforts is for a state to almost simultaneously use both market-driven and regulatory strategies similar to what was implemented in California over the last three decades and in Germany for the last 100 years.
许多州目前在实施医疗领域成本控制措施时面临的一个基本选择是权衡他们应在多大程度上依赖竞争策略或监管策略。为研究美国当前以市场为导向的控制医疗支出方法的成效，对美国健康维护组织（HMO）市场渗透率最高的15个州1993年的医院出院费用及相关数据进行了分析。该研究的主要发现是，运营付费小时数较少的机构对于降低每次出院的平均费用比医院位于“竞争”还是“监管”州更为关键。本文提出，为加强医院成本控制措施，一个州应几乎同时采用市场驱动和监管策略，类似于加利福尼亚州在过去三十年以及德国在过去一百年所实施的策略。
