Fairfield G, Hunter D J, Mechanic D, Rosleff F
Nuffield Institute for Health, University of Leeds.
BMJ. 1997 Jun 21;314(7097):1823-6. doi: 10.1136/bmj.314.7097.1823.
Managed care has entered the lexicon of healthcare reform, but confusion and ignorance surround its meaning and purpose. It seeks to cut the costs of health care while maintaining its quality, but the evidence that it is able to achieve these aims is mixed. As well as raising awareness and understanding of the issues surrounding managed care, this series considers whether managed care is desirable for the NHS. Developed in the United States as a response to spiralling healthcare costs and dysfunctional fragmented services, managed care is not a discrete activity but a spectrum of activities carried out in a range of organisational settings. Due to its constantly changing nature, managed care is a slippery concept--but all its permutations have in common an attempt to influence and modify the behaviour and practice of doctors and other health professionals towards cost effective care. Whatever potential managed care may hold in this regard, careful appraisal of its implications is essential.
管理式医疗已进入医疗改革的词汇表，但人们对其含义和目的仍存在困惑和无知。它试图在维持医疗质量的同时削减医疗成本，但关于它能否实现这些目标的证据并不一致。除了提高对围绕管理式医疗的问题的认识和理解外，本系列还探讨了管理式医疗对英国国家医疗服务体系（NHS）是否可取。管理式医疗是在美国为应对不断攀升的医疗成本和功能失调的分散服务而发展起来的，它不是一项离散的活动，而是在一系列组织环境中开展的一系列活动。由于其性质不断变化，管理式医疗是一个难以捉摸的概念——但其所有变体的共同之处在于试图影响和改变医生及其他医疗专业人员的行为和实践，以实现具有成本效益的医疗服务。无论管理式医疗在这方面可能具有何种潜力，仔细评估其影响都是至关重要的。
