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挪威的一种新的初级保健排班和按人头付费系统:对加拿大有何借鉴意义?

A new primary care rostering and capitation system in Norway: lessons for Canada?

作者信息

Ostbye T, Hunskaar S

机构信息

Department of Epidemiology, Faculty of Medicine, University of Western Ontario, London.

出版信息

CMAJ. 1997 Jul 1;157(1):45-50.

Abstract

Providing every patient with a personal primary care physician or, from the physician's perspective, establishing a stable roster or list of patients is currently being actively debated in Canada. Norway's system of primary care medicine, similar to Canada's, faces many of the same problems. In 1992 a trial rostering system with blended funding (capitation, fee-for-service and user fees) was established in 4 Norwegian municipalities. After 3 years of close monitoring, the results of system evaluations have attracted strong interest. This article reports on the benefits and problems encountered with the new rostering system in Norway. If Canada is moving in the same direction, some of the lessons learned may be helpful.

摘要

目前,加拿大正在积极讨论为每位患者配备一名私人初级保健医生,或者从医生的角度来看,建立一份稳定的患者名单。挪威的初级保健医疗体系与加拿大的类似,也面临着许多相同的问题。1992年,挪威4个城市建立了一个混合资金(按人头付费、按服务收费和用户收费)的试验性名单系统。经过3年的密切监测,系统评估结果引起了强烈关注。本文报告了挪威新名单系统带来的益处和遇到的问题。如果加拿大也朝着相同方向发展,那么所吸取的一些经验教训可能会有所帮助。

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