GLOBAL BUDGETING IN GERMANY - LESSONS FOR THE UNITED-STATES
GLOBAL BUDGETING IN GERMANY - LESSONS FOR THE UNITED-STATES
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DOI：
10.1377/hlthaff.13.4.7
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发表时间：
1994-09-01
期刊：
影响因子：
9.7
通讯作者：
ADE, C
中科院分区：
文献类型：
--
作者：
HENKE, KD;MURRAY, MA;ADE, C
1993 年，德国实施了重大的医疗改革立法，其中包括加强了医生的全球预算并制定了药品支出的全球预算。德国医生的支出现在受到疾病基金成员收入增长的限制，这与前几年不同，前几年允许高于目标水平的增长。牙科服务也首次受到预算上限的限制。新的改革立法还通过提高共付额水平以及将医生作为一个群体置于超出限额的财务风险来限制药品支出的增长。本文考察了这些改革第一年的效果，并为美国制度改革提供了经验教训。
In 1993 Germany implemented significant health reform legislation that, among other things, strengthened the global budgeting of physicians and instituted global budgeting of pharmaceutical expenditures. German physician expenditures are now capped at the growth in income of members of the sickness funds, in contrast to prior years, in which some growth above a targeted level was allowed. For the first time, dental services also are subject to the budget cap. The new reform legislation also limits growth in pharmaceutical expenditures by increasing the level of copayments and by placing physicians as a group at financial risk for growth over the limit. This paper examines the effect of these reforms during the first year and offers lessons for reform of the U.S. system.