Dickey B
Department of Psychiatry, Harvard Medical School, Boston, MA, USA.
Harv Rev Psychiatry. 1994 Jul-Aug;2(2):97-103. doi: 10.3109/10673229409017122.
The debate around health reform has raised questions about costs of care and the nature of competition in the delivery of care. This study examines whether the profit incentive leads to more-cost-efficient delivery of psychiatric and substance-abuse care. The data are from paid claims for 561 psychiatric and substance-abuse admissions in 1985-1987 from two very large national corporations with generous indemnity health plans that included nondiscriminatory mental health benefits. We found that episode-paid claims for admissions to for-profit facilities, after adjustments for case-mix and facility type, were higher. The stays of children in for-profit hospitals, relative to those of adults, were longer and more expensive.
围绕医疗改革的辩论引发了有关医疗成本以及医疗服务提供中竞争性质的问题。本研究探讨了利润激励是否会带来更具成本效益的精神科和药物滥用治疗服务。数据来自1985年至1987年期间两家大型全国性公司的561例精神科和药物滥用住院病例的付费理赔，这两家公司拥有慷慨的赔偿型健康保险计划，其中包括非歧视性的心理健康福利。我们发现，在对病例组合和机构类型进行调整后，营利性机构住院病例的按次付费理赔更高。与成年人相比，营利性医院中儿童的住院时间更长，费用也更高。
