VanderLaan B F, de la Houssaye M, Janousek K, Derus C
Accord Health Network, Westchester, IL, USA.
J Health Care Finance. 1998 Summer;24(4):27-38.
Administrative costs are a major item of concern for capitated provider groups, who must maintain a sophisticated infrastructure to allow them to manage and deliver clinical care to their patients under a fixed budget. The cost of this infrastructure is under steady upward pressure, as HMOs delegate more activities to providers and step up their reporting requirements. Our experience in establishing an infrastructure for a provider network is reported, and indicates substantial costs for both start-up and ongoing operations, which are highly volume dependent. A powerful case exists in favor of centralizing and pooling administrative infrastructure across related provider groups.
行政成本是按人头付费的医疗服务提供方团体主要关注的项目，这些团体必须维持一个复杂的基础设施，以便在固定预算下管理并为患者提供临床护理。随着健康维护组织（HMO）将更多活动委托给医疗服务提供方并提高报告要求，这一基础设施的成本面临持续上升的压力。我们报告了为一个医疗服务提供网络建立基础设施的经验，结果表明启动和持续运营成本都很高，且高度依赖业务量。有充分理由支持跨相关医疗服务提供方团体集中和整合行政基础设施。
