ARE HOSPITAL SERVICES RATIONED IN NEW-HAVEN OR OVER-UTILIZED IN BOSTON
ARE HOSPITAL SERVICES RATIONED IN NEW-HAVEN OR OVER-UTILIZED IN BOSTON
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DOI：
10.1016/s0140-6736(87)92152-0
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发表时间：
1987-05-23
期刊：
影响因子：
168.9
通讯作者：
CULP, WJ
中科院分区：
文献类型：
--
作者：
WENNBERG, JE;FREEMAN, JL;CULP, WJ
纽黑文和波士顿的人口在人口统计学上是相似的，他们的大部分住院治疗都是在大学医院接受的，但在1982年，他们的人均住院治疗支出分别为451美元和889美元。如果按照纽黑文居民的使用率，波士顿的685 400名居民在医院支出上多支出了约3亿美元，使用了739张床位。大多数额外的床位都用于提高医疗条件下的入院率，而这些医疗条件下的入院决定可以自由决定。大手术的总体比率是相等的，但个别手术的比率差异很大。这些发现表明，学术标准的护理与广泛不同的实践模式是一致的，而且在主要由大学医院服务的社区，医疗保健费用不一定高。他们还强调需要更多地注意实践风格差异的结果和所涉成本。
The populations of New Haven and Boston are demographically similar and receive most of their hospital care in university hospitals, but in 1982 their expenditures per head for inpatient care were $451 and $889, respectively. The 685 400 residents of Boston incurred about $300 million more in hospital expenditures and used 739 more beds than they would have if the use rates for New Haven residents had applied. Most of the extra beds were invested in higher admission rates for medical conditions in which the decision to admit can be discretionary. The overall rates for major surgery were equal, but rates for some individual operations varied widely. These fidings indicate that academic standards of care are compatible with widely varying patterns of practice and that medical care costs are not necessarily high in communities served largely by university hospitals. They also emphasize the need for increased attention to the outcome and cost implicatins of differences in practice styles.