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Making the business case for infection control: Pitfalls and opportunities

AMERICAN JOURNAL OF INFECTION CONTROL 2002年第2期30卷 86-92页

作者： Dunagan, WC Murphy, DM Hollenbeak, CS Miller, SB BJC Healthcare St Louis MO 63108 USA Washington Univ Sch Med Div Infect Dis St Louis MO 63130 USA BJC HealthCare Infect Control & Healthcare Epidemiol Consortium St Louis MO 63108 USA Penn State Coll Med Hershey PA USA Barnes Jewish Hosp St Louis MO USA Washington Univ Sch Med Div Nephrol St Louis MO 63130 USA

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SHOULD PHYSICIANS BE PERMITTED TO BALANCE BILL PATIENTS

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JOURNAL OF HEALTH ECONOMICS 1993年第3期12卷 239-258页

作者： GLAZER, J MCGUIRE, TG BOSTON UNIV DEPT ECON270 BAY STAT RDBOSTONMA 02215 TEL AVIV UNIV FAC MANAGEMENTIL-69978 TEL AVIVISRAEL

This paper studies the efficiency effects of physician fees when the insurer (possibly the government) pays a fee for each procedure, and the doctor may supplement the fee by an extra charge to the patient, a practice known as 'balance billing.' Monopolistically competitive physicians can discriminate among patients on the basis of both price and quality. Equilibria with and without balance billing are compared. The paper analyzes and recommends a new fee policy, a form of payer 'fee discrimination.'

关键词：费用分担/标准效率组织/经济学费用医疗/标准 MedicareB部/经济学模型统计学病人记账和收款/经济学医师/经济学卫生保健质量/经济学支付标准制定和审核/标准美国

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QUALITY OF MENTAL-HEALTH-SERVICES AND METHOD OF PAYMENT - AN EMPIRICAL-STUDY

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BEHAVIORAL SCIENCES & THE LAW 1991年第2期9卷 163-177页

作者： WALLACE, DH CENT MISSOURI STATE UNIV DEPT CRIMINAL JUSTICEWARRENSBURGMO 64093 USA

Data from a sample of clinicians are examined to study the relationship of the lower socio-economic client and therapist. Therapist practice variables are regressed on variables measuring client income and contrasting client's use of Medicaid with the use of private insurance or out-of-pocket funds. It is found that therapist practice variables can predict a significant proportion of the variance of these criterion variables. These relationships and their implications for the therapeutic needs of indigent clients with less severely impaired conditions are discussed.

关键词：方差分析医务工作者的态度卫生服务易得程度 Medicaid 精神障碍/经济学精神障碍/治疗精神卫生服务/经济学内布拉斯加卫生保健质量/经济学问卷调查回归分析偿还途径/经济学社会经济因素人类

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HOSPITAL NONPRICE COMPETITION AND MEDICARE REIMBURSEMENT POLICY

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JOURNAL OF HEALTH ECONOMICS 1989年第2期8卷 147-172页

作者： POPE, GC HLTH ECON RES INC NEEDHAMMA 02194 USA

This paper analyzes the role of interhospital nonprice competition in Medicare's Prospective Payment System. Competition can play an important role both by increasing quality and reducing managerial slack. The quality-enhancing aspect of competition can be amplified through reimbursement of a proportion of incurred cost. As competition intensifies, the optimal degree of cost sharing (subsidy) falls.

关键词：成本及成本分析经济竞争经济学医院效率收入卫生服务使用研究 Medicare/经济学模型统计学预期支付系统/经济学卫生保健质量/经济学美国

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FINANCING LONG-TERM CARE UNDER MEDICAID - COMPETITIVE BIDDING, VOUCHERS AND EXPENDITURE MATCHING IN AN HMO FRAMEWORK

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SOCIO-ECONOMIC PLANNING SCIENCES 1983年第3期17卷 131-140页

作者： HOGAN, AJ Wisconsin Health Care and Research Inc. 6417 Odana Road Madison WI 53719 U.S.A

Within the framework of a Long Term Care--HMO, a series of innovative financing mechanisms are proposed to encourage efficiency, reduce cost increases and promote the quality of long term care. Competitive bidding is used to set prices for long term care. Based upon these competitively set prices, HMO enrollees are given long term care vouchers with which to purchase care. Cost savings, arising from choices of care less expensive than the value of the voucher, are shared with the enrollee and the case management team. Incentive payments to this team are made only after a quality of care review. A portion of the payment to the long term care provider is set aside as a quality assurance withhold. If quality of care is inadequate, the withhold is forfeit.

关键词：健康维护组织/经济学长期医疗/经济学 Medicaid/经济学卫生保健质量/经济学美国

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PROTECTING THE POOR UNDER COST RECOVERY - THE ROLE OF MEANS TESTING

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HEALTH POLICY AND PLANNING 1995年第3期10卷 241-256页

作者： WILLIS, CY LEIGHTON, C ABT ASSOCIATES INC 4800 MONTGOMERY LANESUITE 600BETHESDAMD 20814 USA

In African health sectors, the importance of protecting the very poor has been underscored by increased reliance on user fees to help finance services. This paper presents a conceptual framework for understanding the role means testing can play in promoting equity under health care cost recovery. Means testing is placed in the broader context of targeting and contrasted with other mechanisms. Criteria for evaluating outcomes are established and used to analyze previous means testing experience in Africa. A survey of experience finds a general pattern of informal, low-accuracy, low-cost means testing in Africa. Detailed household data from a recent cost recovery experiment in Niger, West Africa, provides an unusual opportunity to observe outcomes of a characteristically informal means testing system. Findings from Niger suggest that achieving both the revenue raising and equity potential of cost recovery in sub-Saharan Africa will require finding ways to improve informal means testing processes.

关键词：非洲费用分担发展中国家按诊疗收费计划卫生服务易得程度/经济学收入/分类尼日尔试点项目贫困/分类公共卫生管理/经济学卫生保健质量/经济学

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Value-based cost management: the foundation of a balanced performance measurement system.

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Journal for healthcare quality : official publication of the National Association for Healthcare Quality 1997年第4期19卷 6-9;quiz23页

作者： Castañeda-Méndez, K. [?]Kicab Casta?eda-Méndez founded aejes Seminars & Consulting in 1991 the Ridgefield CT firm helps healthcare organizations fine-tune their continuous quality improvement efforts. He has 20 years of experience as an educator consultant and author on quality statistics and education in the United States Latin America and Europe.

Healthcare organizations need critical performance measures if they are to lead, manage, and operate effectively. Traditional financial measures or report cards on patient satisfaction and clinical outcomes are insufficient, however. Value-based cost management directly links cost accounting, processes, clinical outcomes, and patient and employee satisfaction through organizational, work environment, and financial relations measures. These measures address three levels of performance: strategic, diagnostic, and operational. Their linkages identify value in three areas: business-related financial and operational measures;employee-related measures such as those related to satisfaction and well-being;and learning and patient-related measures linked to clinical outcomes, satisfaction, and population.

关键词：费用控制教育继续效率组织管理审计/经济学管理审计/方法病人满意度过程评价(卫生保健)/经济学卫生保健质量/经济学全面质量管理/方法美国人类

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COMPETITION AMONG HOSPITALS

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JOURNAL OF HEALTH ECONOMICS 1988年第3期7卷 259-284页

作者： NOETHER, M ABT ASSOCIATES INC CAMBRIDGEMA 02138 USA

The traditional view of hospital competition has posited that hospitals compete primarily along 'quality' dimensions, in the form of fancy equipment to attract admitting physicians and pleasant surroundings to entice patients. Price competition among hospitals is thought to be non-existent. This paper estimates the effects of various hospital market characteristics on hospital prices and expenses in an attempt to determine the form of hospital competition. The results suggest that both price and quality competition are greater in markets that are less concentrated, although the net effect of the two on prices is insignificant. It appears, therefore, that, despite important distortions, hospital markets are not immune to standard competitive forces.

关键词：卫生服务范围/经济学数据收集经济竞争经济学经济学医院/统计学和数值数据评价研究(主题) 费用和收费/统计学和数值数据卫生服务使用研究/经济学模型统计学卫生保健质量/经济学回归分析美国

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The initial impact of the Medicare prospective payment system on U.S. health care: a review of the literature.

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Medical care review 1991年第1期48卷 91-115页

作者： Feinglass, J. Holloway, J.J. Northwestern University Medical School. United States

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PROSPECTIVE AND COST-PLUS MEDICAID REIMBURSEMENT, EXCESS MEDICAID DEMAND, AND THE QUALITY OF NURSING-HOME CARE

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JOURNAL OF HEALTH ECONOMICS 1985年第3期4卷 237-259页

作者： NYMAN, JA UNIV IOWA IOWA CITYIA 52242 USA

This paper hypothesizes that the Medicaid reimbursement payment discourages quality nursing home care in markets with excess demand. It further shows that an increase in the prospective payment or an increase in the return on capital portion of a retrospective cost-plus payment decreases the quality provided when there is excess demand. Finally, it argues that excess demand destroys a costless signal of quality, namely, the degree of excess capacity in a home, making it more difficult for uninformed consumers to make accurate choices and resulting in markets exhibiting the characteristics of adverse selection. These hypotheses are tested using Wisconsin data.

关键词：卫生服务需求卫生服务研究 Medicaid/经济学模型理论医护疗养所/标准卫生保健质量/经济学偿还途径统计数据威斯康星

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