Sisk J E
Columbia University School of Public Health, New York, NY 10032, USA.
Milbank Q. 1998;76(4):687-707, 512. doi: 10.1111/1468-0009.00110.
Available information does not indicate either that quality has deteriorated as price competition has increased or that quality has improved. To reward plans for providing what consumers want, public and private policies have crucial roles in the following areas: mandating minimal requirements for plans; funding research to improve knowledge and methods related to quality-of-care assessment; publication of quality-of-care information; selective contracting and regionalizing of services; and payment for physician services. Learning what degree of trade-off between cost versus quality and other benefits is acceptable to consumers will be an iterative process that informs future policies to safeguard the quality of care.
现有信息既未表明随着价格竞争加剧质量有所下降,也未表明质量有所提高。为奖励计划提供消费者所需的服务,公共政策和私人政策在以下方面发挥着关键作用:规定计划的最低要求;资助研究以改进与医疗质量评估相关的知识和方法;公布医疗质量信息;服务的选择性签约和区域化;以及支付医生服务费用。了解消费者可接受的成本与质量及其他益处之间的权衡程度将是一个反复的过程,可为未来保障医疗质量的政策提供参考。