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浙江大学学报（医学版） 2016年第3期45卷 323-329页

作者：何苗唐晓君龙倩韦杰孙振兴杨雪巍汤胜蓝重庆医科大学流行病学教研室公共卫生与管理学院医学与社会发展研究中心国民健康社会风险预警协同创新中心重庆400016 美国杜克大学全球健康研究所北卡罗来纳州达勒姆27710

目的：比较重庆市已纳入慢病管理系统2型糖尿病患者中，有、无特殊疾病医疗保险（简称特病医保）者之间的治疗费用情况及可能影响申请该特病医保的因素。方法：采用结构化问卷，调查患者的基本信息及与糖尿病有关的药房、门诊、住院治... 详细信息

目的：比较重庆市已纳入慢病管理系统2型糖尿病患者中，有、无特殊疾病医疗保险（简称特病医保）者之间的治疗费用情况及可能影响申请该特病医保的因素。方法：采用结构化问卷，调查患者的基本信息及与糖尿病有关的药房、门诊、住院治疗费用情况。使用SAS9．1软件进行数据统计分析，计数资料分析采用∥检验，有统计学差异的变量再纳入多因素逐步logistic回归模型。连续性变量用中位数（四分位数间距）[M（Q）]来表示，采用Wilcoxon秩和检验。结果：门诊组有特病医保的患者年人均总费用[2160（3081）元]较无特病医保的患者高[1000（2100）元，P〈0．01]，年次均自费比例（54．04％）低于无特病医保患者的自费比例（93．78％，P〈0．01）。就申请特病医保而言，中等收入水平（OR=1．94）、高收入水平（OR=2．11）、参加城镇职工医疗保险（OR=4．19）、病程超过5年（OR=2．04）都是其可能的影响因素，具有这些特征的患者相对更容易申请到特病医保。结论：为缓解2型糖尿病患者经济负担，政府应大力宣传特病医保的相关政策，鼓励患者主动了解，积极申报。同时，医保部门与医疗机构应加强监管，简化办理流程，建议增加特殊疾病定点零售药店的数量和覆盖面，提高特病医保利用的可及性。同时，应更加关注低收入人群和病程相对较短的患者，增强他们抵御疾病经济风险的能力，提高特病医保的利用及公平性。

关键词：糖尿病,2型/经济学保险,健康卫生保健费用费用,医疗费用和收费/统计学和数值数据问卷调查回归分析

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ASSESSING THE EFFECT OF VENDORSHIP ON FEE SETTING FOR SOCIAL-WORKERS - AN EMPIRICAL-TEST

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SOCIAL WORK RESEARCH & ABSTRACTS 1991年第1期27卷 28-33页

作者： LIEBERMAN, AA TURNER, WM HARVARD UNIV SCH MED BROCKTON VET ADM MED CTR BOSTON MA 02115 USA

Examines the monopolistic competition model for its adequacy as a predictive tool for determining factors that influence fee setting among private practice social workers. Indication of responsiveness of price of psychotherapy in the social worker's primary practice setting to demand; Discussion of reimbursement policy implications.

关键词：商业/立法和法学经济竞争/立法和法学费用和收费/统计学和数值数据保险精神病最小二乘法分析缅因马萨诸塞模型统计学私人开业/经济学支付标准制定和审核回归分析社会工作精神病/经济学

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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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Risk issues in claims reported by 85 small hospitals.

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Journal of healthcare risk management : the journal of the American Society for Healthcare Risk Management 1993年第3期13卷 31-37页

作者： Brown, B.S. Clause, M.A. Virginia Insurance Reciprocal Richmond United States

According to one business adage, 20 percent of one's activity reflects 80 percent of one's success. Although few managers in small hospitals spend more than 20 percent of their time on credentialing and peer review, those activities are likely to have the most impact on preventing claims in small hospitals. Other strategies that may enhance these activities include redefining the types of services offered when professional staff, resources for new services, and staff education are scarce. Help with developing sound peer review and credentialing practices can be found through networking within professional organizations, in documents published by national organizations, and by using professional risk management services available through liability carriers. Devoting time to improving providers' documentation skills, monitoring key technical skills of health care providers, and analyzing patient flows from provider to provider and service to service are also likely to have an impact on losses in small hospitals.

关键词：数据收集评价研究费用和收费/统计学和数值数据卫生服务研究医院病床数 100张以下医院社区/经济学医院社区/统计学和数值数据保险索赔审核/统计学和数值数据保险责任/经济学保险责任/统计学和数值数据责任法律危险处理/经济学危险处理/统计学和数值数据美国东南部

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METHODS OF DETERMINING THE COST OF HEALTH-CARE IN THE DEPARTMENT OF VETERANS AFFAIRS MEDICAL-CENTERS AND OTHER NON-PRICED SETTINGS

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EVALUATION & THE HEALTH PROFESSIONS 1991年第3期14卷 282-303页

作者： CHAPKO, MK EHRETH, JL HEDRICK, S UNIV WASHINGTON SEATTLEWA 98195 USA

Cost is increasingly important in the evaluation of health care. Though charges are often used as a proxy for cos4 some health care systems such as the Veterans Administration do little or no billing. This article describes, presents examples of and evaluates four options for determining the cost of care within the Department of Veterans Affairs: measuring input costs, the Departmen t's cost accounting system, the reimbursement system, and use of charges from a surrogate health care facility. Each approach is evaluated for accuracy, ability to compare the costs of different treatments, and effort required to estimate cost.

关键词：会计学/方法费用分配/方法直接服务费用/统计学和数值数据费用和收费/统计学和数值数据卫生保健费用/统计学和数值数据医院退伍军人/经济学偿还途径美国美国退伍军人事务部

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Charging for library and information services in medical libraries: a review of the literature and a survey of current practice.

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Health libraries review 1993年第4期10卷 202-223页

作者： Webber, S. Department of Information Science University of Strathclyde Glasgow United Kingdom

A summary of some of the issues concerned with charging for library services (particularly information services and services provided by medical libraries) is given. The results of a survey carried out in July 1992 are presented. The survey asked respondents to indicate which library services they charged for, the level of charges and the extent to which charges to those outside the organization and those within it differed. Twenty-five libraries (response rate of 69%) replied to the survey. Some further areas for research and discussion are indicated.

关键词：决策组织费用和收费/统计学和数值数据大不列颠信息系统/经济学信息系统/统计学和数值数据图书馆医学/经济学图书馆医学/统计学和数值数据图书馆服务/分类图书馆服务/经济学图书馆服务/统计学和数值数据问卷调查支付标准制定和审核/方法支付标准制定和审核/统计学和数值数据

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TAX HARMONIZATION AND THE REDUCTION OF EUROPEAN SMOKING RATES

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JOURNAL OF HEALTH ECONOMICS 1992年第3期11卷 329-346页

作者： TRIGG, AB BOSANQUET, N UNIV LONDON ROYAL HOLLOWAY & BEDFORD NEW COLL DEPT SOCIAL POLICY EGHAM TW20 0EX SURREY ENGLAND

Amidst growing optimism that smoking in Europe can be greatly reduced by the year 2000, this paper simulates the possible impacts of European tax harmonisation in the context of rising incomes. A range of price and income elasticities are chosen from econometric studies which use micro information. This is justified by the aggregation problems associated with studies in the smoking literature which use aggregate data. Using micro elasticities, the simulations reported in this paper show that the aims of fiscal harmonisation are at variance with the aims of health promotion.

关键词：成本及成本分析/统计学和数值数据欧洲/流行病学费用和收费/统计学和数值数据健康行为健康促进/经济学模型经济计量学回归分析吸烟/经济学吸烟/流行病学社会经济因素税款/统计学和数值数据世界卫生组织人类

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TAXATION, REGULATION, AND ADDICTION - A DEMAND FUNCTION FOR CIGARETTES BASED ON TIME-SERIES EVIDENCE

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JOURNAL OF HEALTH ECONOMICS 1993年第1期12卷 1-18页

作者： KEELER, TE HU, TW BARNETT, PG MANNING, WG UNIV CALIF BERKELEY SCH PUBL HLTHBERKELEYCA 94720 UNIV MINNESOTA SCH PUBL HLTHDIV HLTH SCI RES & POLICYMINNEAPOLISMN 55455

This work analyzes the effects of prices, taxes, income, and anti-smoking regulations on the consumption of cigarettes in California (a 25-cent-per-pack state tax increase in 1989 enhances the usefulness of this exercise). Analysis is based on monthly time-series data for 1980 through 1990. Results show a price elasticity of demand for cigarettes in the short run of -0.3 to -0.5 at mean data values, and -0.5 to -0.6 in the long run. We find at least some support for two further hypotheses: that antismoking regulations reduce cigarette consumption, and that consumers behave consistently with the model of rational addiction.

关键词：加利福尼亚/流行病学数据收集评价研究(主题) 费用和收费/统计学和数值数据健康行为收入/统计学和数值数据最小二乘法分析模型心理学吸烟/经济学吸烟/流行病学吸烟/立法和法学税款/立法和法学烟草对健康的危害/经济学烟草对健康的危害/流行病学人类

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COST DIFFERENCES BETWEEN HOSPICE AND NONHOSPICE CARE - A COMPARISON OF INSURER PAYMENTS AND PROVIDER CHARGES

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EVALUATION & THE HEALTH PROFESSIONS 1989年第2期12卷 159-178页

作者： BROOKS, CH CLEVELAND STATE UNIV HLTH CARE ADMCLEVELANDOH 44115 USA

Although it has been postulated that hospice care savings are "biased" when costs are measured in terms of insurer payments instead of provider charges, this claim has not been documented by research. This article examines cost differences between hospice and nonhospice care, first, by analyzing Medicare Part A payments and, second, by studying provider charges for services rendered to a population of 24 cancer patients during their last 24 weeks of life. The exploratory results of the study showed that although the cost savings derived from analyzing provider charges were about double those based on Medicare Part A payments, both approaches to the measurement of cost strongly indicated that hospice home care was less costly than nonhospice care. Further analysis showed that variations in the rates of Medicare reimbursement accounted for 22 to 42% of the differences in the derived cost savings between the two approaches to measuring cost, and that payments to hospitals played a major role in determining this outcome.

关键词：费用效益分析费用和收费/统计学和数值数据家庭医疗保健服务/经济学临终关怀医院/经济学住院/经济学 Medicare/统计学和数值数据肿瘤/经济学俄亥俄老年人人类

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THE EFFECTS OF MARKET-STRUCTURE AND BARGAINING POSITION ON HOSPITAL PRICES

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JOURNAL OF HEALTH ECONOMICS 1992年第3期11卷 217-233页

作者： MELNICK, GA ZWANZIGER, J BAMEZAI, A PATTISON, R UNIV CALIF LOS ANGELES SCH PUBL HLTHLOS ANGELESCA 90024 UNIV ROCHESTER ROCHESTERNY 14627 A&N TECH SERV INC SANTA MONICACA PATTISON & ASSOC BERKELEYCA BLUE CROSS CALIF OAKLANDCA

PPOs and HMOs have pined widespread acceptance due in part to the belief that excess capacity and competitive market conditions can be leveraged to negotiate lower prices with health care providers. We investigated prices obtained in different types of markets by the largest PPO in California. Our findings indicate that greater hospital competition leads to lower prices. Furthermore, as the importance of a hospital to the PPO in an area increases, the price rises substantially. Our testing of alternative methods for defining hospital geographic markets reveals that the common practice of using counties to define the market leads to an underestimate of the price-increasing effects of a merger.

关键词：蓝十字蓝盾保险计划/经济学蓝十字蓝盾保险计划/统计学和数值数据加利福尼亚卫生服务范围/经济学卫生服务范围/统计学和数值数据合同业务/经济学经济竞争费用和收费/统计学和数值数据财务管理医院/经济学财务管理医院/统计学和数值数据卫生服务研究模型经济计量学优先提供医疗服务组织/经济学优先提供医疗服务组织/统计学和数值数据转诊和会诊/经济学回归分析

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