Financing of care for fatal chronic disease: opportunities for Medicare reform.
Financing of care for fatal chronic disease: opportunities for Medicare reform.
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致命慢性病护理的融资：医疗保险改革的机会。
DOI：
10.1136/ewjm.175.5.299
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发表时间：
2001
期刊：
影响因子：
--
通讯作者：
L. Etheredge
中科院分区：
文献类型：
--
作者：
J. Lynn;Anne Wilkinson;L. Etheredge
融资安排是否会影响“更好的护理课程”是否会变得普遍？一些缺点，在照顾病人最终致命的慢性疾病产生不充分的专业教育和质量标准，1但医疗保健专业人士和专家小组还声称，不适当的医疗保险覆盖面和支付政策，使功能失调的安排，在护理系统。
四分之三的美国人在65岁以上死亡。1因此，医疗保险政策构成了在生命结束时接受护理的模式。超过四分之三的人死于慢性心脏或肺衰竭，癌症，中风或痴呆症。在此期间，他们经常接受不可靠、不充分、不适当、不想要和昂贵的护理。1，5，6生命最后一年的医疗保健占整体医疗保健支出的11%，占联邦医疗保险支出的27%。
Could financing arrangements influence whether the “better course of care” could become commonplace? Some shortcomings in care for patients with eventually fatal chronic conditions arise from inadequate professional education and quality standards,1 but health care professionals and expert panels also claim that inappropriate Medicare coverage and payment policies perpetuate dysfunctional arrangements in the care system.2,3 In this article, we show how financing might contribute to the perpetuation of inadequate care and suggest remedies for such situations.
Three fourths of Americans die past 65 years of age.1 Thus, Medicare policy structures the pattern of care received at the end of life. More than three quarters of those dying in Medicare have chronic heart or lung failure, cancer, stroke, or dementia.4 Not only are most people very sick just before death, they also will have been very sick for many months earlier. During that time, they often receive care that is unreliable, inadequate, inappropriate, unwanted, and costly.1,5,6 Medical care in the last year of life accounts for 11% of overall health care spending and 27% of Medicare spending.7,8