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影响医疗服务成本的核心因素是管理体制。不同管理体制对医疗服务的生产成本、治疗成本和健康成本控制具有不同的形式。美国、英国和加拿大在管理体制上各有不同。美国在服务的生产和提供上依托市场竞争,英国和加拿大则政府参与的程度很高。其对三种成本的管理给了我们很多启示:必须促使服务提供者进行相互竞争以控制生产成本;在不断增加投入的基础上,确定一个或多个统一的支付者以控制治疗成本;支付者要把支付基础从服务量向价值转换以控制健康成本。当务之急是逐步实现基于病种的预付制。
The key factor affecting the cost of medical services is the management system. Different management systems have different forms of control over production costs, treatment costs and health costs of medical services. The United States, Britain and Canada have different regulatory systems. The United States relies on market competition in the production and supply of services, while the United Kingdom and Canada have a very high level of government involvement. Its management of the three costs gives us a lot of inspiration: service providers must be competing to control the cost of production; in increasing investment, based on the determination of one or more unified payer to control the cost of treatment; payers The payment base should be shifted from value to volume to control health costs. The top priority is to progressively achieve pre-payment based on disease types.