Kovac M
Medical and Pharmaceutical Research Section, Health and Family Services Branch, Commonwealth Department of Finance and Administration Australia, Australian Capital Territory, Canberra, Australia.
Croat Med J. 1998 Sep;39(3):339-45.
This article reports on the rationing in the Australian hospital sector and explains why it has been undertaken. It also briefly overviews the Australian health system in order to provide a necessary background for the issue of rationing itself. Rationing of hospital services has occurred because governments in Australia have limited hospital sector resources trying to ensure the containment of their health budgets. The resources available to hospitals have been insufficient to ensure that the supply of services meets the demand for such services. Therefore, in order to contain hospital budgets rationing has been required. Medicare, the universal health insurance system, assures that access to public hospital services is on the basis of clinical needs. However, due to the federal nature of government in Australia, the available services are determined by health system structural interrelationships and direct government regulation. For example, services provided in the community sector, and funded by the Commonwealth government, are prime candidates for being removed from the hospital sector by State/Territory governments. Similarly, expensive services with a wide range of usage are candidates for regulation to contain costs.
本文报道了澳大利亚医院部门的医疗资源配给情况，并解释了为何要进行配给。为了给医疗资源配给问题提供必要的背景信息，文章还简要概述了澳大利亚的医疗体系。澳大利亚医院服务的配给之所以出现，是因为澳大利亚政府试图限制医院部门资源，以控制其医疗预算。医院可获得的资源不足以确保服务供给满足此类服务的需求。因此，为了控制医院预算，就需要进行配给。全民医疗保险体系“医疗保险”确保了公立医院服务的获取基于临床需求。然而，由于澳大利亚政府的联邦性质，可用服务由医疗体系的结构相互关系和政府直接监管决定。例如，由联邦政府资助的社区部门提供的服务，很可能被州/领地政府从医院部门移除。同样，使用范围广泛的昂贵服务也可能受到监管以控制成本。
