Wiener J M
Health Policy Center, Urban Institute, Washington, DC 20037, USA.
Gerontologist. 1996 Dec;36(6):800-11. doi: 10.1093/geront/36.6.800.
During 1995 and 1996 Congress debated numerous proposals that would dramatically reduce the rate of growth in Medicaid spending, initiatives that inevitably would affect long-term care for the elderly. There are three broad strategies that states might use to control long-term care spending-bring more private resources into the long-term care system to offset Medicaid's expenditures, reform the delivery system so that care can be provided more cheaply, and reduce Medicaid eligibility, reimbursement, and service coverage. Based on the available research evidence, there is little evidence to suggest that large savings are possible without adversely affecting beneficiaries' eligibility, access to services, and quality of care received.
1995年至1996年期间，国会对多项大幅降低医疗补助支出增长率的提案进行了辩论，这些举措不可避免地会影响老年人的长期护理。各州可能采用三种广泛的策略来控制长期护理支出：将更多私人资源引入长期护理系统以抵消医疗补助的支出；改革服务提供系统，以便能更廉价地提供护理；降低医疗补助的资格标准、报销额度和服务覆盖范围。根据现有的研究证据，几乎没有证据表明在不对受益人资格、服务可及性和所接受护理质量产生不利影响的情况下能实现大幅节省开支。
