Stajduhar P, Deneselya J A, Rajachar M, Werner G, Kennard D W, Klingensmith J M
Department of Veterans Affairs, Medical Center, Butler, Pennsylvania, USA.
Am J Med Qual. 1996 Fall;11(3):146-50. doi: 10.1177/0885713X9601100306.
This study addresses the cost of rural health care delivery where veterans do not have ready access to tertiary Department of Veterans Affairs Medical Centers (VAMCs) but where local community health care is available. The study sample was 209 patients referred for tertiary care to a VAMC 50 miles distant from the referring rural VAMC. The cost of tertiary referral VAMC care was retrospectively compared with the cost had the patients received the tertiary care in the local community hospital located in the immediate vicinity. In addition, the cost of travel resulting from the remote access was also computed. Findings indicate that a savings of +309,293 could have been obtained had a local community hospital provided the tertiary care utilizing the Health Care Financing Administration Medicare rate. Data generated by the methodology of this study are expected to provide a baseline for policy decisions relating to alternative pathways for tertiary care in the Department of Veterans Affairs.
本研究探讨了农村地区医疗服务的成本，在这些地区，退伍军人无法便捷地前往三级退伍军人事务部医疗中心（VAMC），但当地有社区医疗服务。研究样本为209名被转诊至距离转诊农村VAMC 50英里远的三级医疗VAMC的患者。回顾性比较了三级转诊VAMC护理的成本与患者在紧邻的当地社区医院接受三级护理的成本。此外，还计算了因远程就医产生的交通成本。研究结果表明，如果当地社区医院按照医疗保健财务管理局医疗保险费率提供三级护理，可节省309,293美元。预计本研究方法所产生的数据将为退伍军人事务部三级护理替代途径的政策决策提供基线。
