Green-McKenzie J, Parkerson J, Bernacki E
Division of Occupational Medicine, School of Medicine, School of Hygiene and Public Health, Johns Hopkins University, Baltimore, Md., USA.
J Occup Environ Med. 1998 Jun;40(6):568-72. doi: 10.1097/00043764-199806000-00010.
A comprehensive safety and managed care initiative was instituted in 1991 at a large self-insured medical center in an effort to reduce workers' compensation costs. It features an on-site case management team, a preferred provider organization, and safety engineering efforts and ergonomic controls used proactively to aggressively identify and abate workplace hazards. Two worker populations were followed up longitudinally for three years before and after the initiative. Costs incurred by each cohort were compared. A 50% reduction in total expenditures was seen in the managed care cohort. The hospital component of the system saw a decrease in compensation of 62% for temporary total disability and 38% for permanent partial disability. Medical expenditures decreased 50%. Dramatic reductions in costs are achievable, without compromising quality of care, when managed care principles and safety efforts are emphasized.
1991年，一家大型自保医疗中心发起了一项全面的安全与管理式医疗倡议，旨在降低工伤赔偿成本。该倡议的特色包括一个现场病例管理团队、一个优选医疗机构组织，以及积极主动地用于大力识别和消除工作场所危害的安全工程措施和人体工程学控制手段。在该倡议实施前后，对两组工人进行了为期三年的纵向跟踪。比较了每个队列产生的费用。在管理式医疗队列中，总支出减少了50%。该系统的医院部分，临时全残赔偿减少了62%，永久部分残疾赔偿减少了38%。医疗支出减少了50%。当强调管理式医疗原则和安全措施时，在不影响医疗质量的情况下，成本可大幅降低。
