Lázaro P, Fitch K
Instituto de Salud Carlos III.
Int J Technol Assess Health Care. 1996 Fall;12(4):735-44. doi: 10.1017/s0266462300011016.
We studied the role of economic incentives for private providers in explaining Spain's disproportionately large number of extracorporeal shock wave lithotripters (ESWLs) and low number of linear accelerators (linacs) per million population (pmp) in comparison to other countries of the Organization for Economic Cooperation and Development (OECD). We found that the reimbursement policy for 1990 allowed an average profit per private ESWL of $732,000, but no profit for linacs. Regional per-capita income was positively correlated with ESWLs pmp in Spain (R2 = 0.49; p = .001), but not with linacs. Sixty-nine percent of ESWLs were privately held versus only 16% of linacs. To avoid these types of distortions, financial incentives should be based on a reasonable relationship between cost and charges and should be associated with the appropriateness of medical care.
我们研究了经济激励措施对私人医疗服务提供者的作用，以解释西班牙与经济合作与发展组织（经合组织）其他国家相比，每百万人口（pmp）体外冲击波碎石机（ESWL）数量过多而直线加速器（直线加速器）数量过少的原因。我们发现，1990年的报销政策允许每台私人ESWL平均盈利73.2万美元，但直线加速器无盈利。西班牙的地区人均收入与每百万人口的ESWL数量呈正相关（R2 = 0.49；p = 0.001），但与直线加速器数量无关。69%的ESWL是私人拥有的，而直线加速器只有16%。为避免这类扭曲现象，经济激励措施应基于成本与收费之间的合理关系，并应与医疗服务的适当性相关联。
