Braithwaite J, Hindle D, Phelan P D, Hanson R
School of Health Services Management, Faculty of Medicine, University of New South Wales, Sydney.
Med J Aust. 1998 Jun 1;168(11):558-62. doi: 10.5694/j.1326-5377.1998.tb139084.x.
Casemix funding for hospitals with the use of diagnosis-related groups (DRGs), which organise patients' conditions into similar clinical categories with similar costs, was introduced in Australia five years ago. It has been applied in different ways and to a greater or lesser extent in different Australian States. Only Victoria and South Australia have implemented casemix funding across all healthcare services. Attempts have been made to formally evaluate its impact, but they have not met the required scientific standards in controlling for confounding factors. Casemix funding remains a much-discussed issue. In this Debate, Braithwaite and Hindle take a contrary position, largely to stimulate policy debate; Phelan defends the casemix concept and advocates retaining its best features; and Hanson adds a plea for consumer input.
五年前,澳大利亚引入了基于诊断相关分组(DRGs)的医院病例组合资金制度,该制度将患者病情归类为成本相似的临床类别。它在澳大利亚不同州以不同方式、不同程度得到应用。只有维多利亚州和南澳大利亚州在所有医疗服务中实施了病例组合资金制度。人们曾试图对其影响进行正式评估,但在控制混杂因素方面未达到所需的科学标准。病例组合资金制度仍是一个备受讨论的问题。在本次辩论中,布雷斯韦特和欣德尔持相反立场,主要是为了激发政策辩论;费兰为病例组合概念辩护,并主张保留其最佳特征;汉森则呼吁纳入消费者意见。