THE EFFECTIVENESS OF A REGULATORY STRATEGY IN CONTAINING HOSPITAL COSTS - THE ONTARIO EXPERIENCE, 1967-1981
THE EFFECTIVENESS OF A REGULATORY STRATEGY IN CONTAINING HOSPITAL COSTS - THE ONTARIO EXPERIENCE, 1967-1981
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DOI：
10.1056/nejm198307213090306
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发表时间：
1983-01-01
影响因子：
158.5
通讯作者：
BOMBARDIER, C
中科院分区：
文献类型：
--
作者：
DETSKY, AS;STACEY, SR;BOMBARDIER, C
本研究记录了 1968 年至 1981 年间安大略省医院部门实际投入（例如劳动力和设备）的增长情况，这是政府资助的全民医院保险和涉及全球预算的政府监管战略的时期。按实际投入计算，安大略省的总支出仅增加了 16%，而美国则增加了 101%。安大略省每患者日的实际投入年均增长率为 0.68%，而美国为 5.19%（P<0.001）。安大略省每次入学的实际投入年均下降 1.12%，而美国则增加 4.15%（P<0.0001）。我们的结论是，即使激励结构不能提高患者或医生的成本意识，监管也可以遏制医院部门实际投入的增长。尽管这一策略对护理质量的影响尚不清楚，但到目前为止，它似乎在安大略省在政治上是可以接受的。 （新英格兰医学杂志 1983；309：151-9。）
This study documents the increases in real inputs (e.g., labor and equipment) employed in Ontario's hospital sector between 1968 and 1981—a period of universal government-financed hospital insurance and a government regulatory strategy involving global budgeting.Total expenditures in Ontario increased by only 16 per cent in terms of real inputs, as compared with an increase of 101 per cent in the United States. Real inputs per patient-day increased at a mean annual rate of 0.68 per cent in Ontario versus 5.19 per cent in the United States (P<0.001). Real inputs per admission decreased at a mean annual rate of 1.12 per cent in Ontario, as compared with an increase of 4.15 per cent in the United States (P<0.0001). We conclude that regulation can contain the growth of real inputs employed in the hospital sector even in the face of an incentive structure that does not promote cost consciousness on the part of patients or physicians. Although the effect of this strategy on the quality of care is unknown, so far it appears to have been politically acceptable in Ontario. (N Engl J Med 1983; 309:151–9.)