Spencer C S
Johns Hopkins University, USA.
J Health Polit Policy Law. 1998 Feb;23(1):53-73. doi: 10.1215/03616878-23-1-53.
In 1983, New York State established an uncompensated care pool using the New York Prospective Hospital Reimbursement Methodology (NYPHRM). Two policy objectives of the NYPHRM were (1) to encourage more equitable distribution of uncompensated care across hospitals and (2) to increase access to hospital care for the uninsured. This article demonstrates that the New York uncompensated care pool was only moderately successful in achieving these goals. The principal findings are that the NYPHRM did result in routine care being redistributed away from hospitals that traditionally provided care to the uninsured, while provision of highly technological care was not significantly redistributed. This article suggests that if the primary policy goal is to increase access to care for the uninsured by changing the distribution of hospitals willing to provide care, the uncompensated care pool approach is moderately effective.
1983年，纽约州利用纽约预期医院报销方法（NYPHRM）设立了一个无偿护理池。NYPHRM的两个政策目标是：（1）鼓励在各医院之间更公平地分配无偿护理；（2）增加未参保者获得医院护理的机会。本文表明，纽约的无偿护理池在实现这些目标方面仅取得了一定程度的成功。主要研究结果是，NYPHRM确实导致常规护理从传统上为未参保者提供护理的医院重新分配出去，而高科技护理的提供并未发生显著重新分配。本文认为，如果主要政策目标是通过改变愿意提供护理的医院分布来增加未参保者获得护理的机会，那么无偿护理池方法具有一定的效果。
