医疗服务预算管理与卫生资源公平分配——美国VERA改革对我国的启示
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摘要
我国医疗服务系统在实现横向合作和纵向整合的过程中,需要建立有效的资金分配制度和激励机制,从而提高医疗服务系统的服务质量和效率。美国退役军人医疗系统实行按人头分配预算、按疾病复杂程度和地区差异等因素调整预算的改革历程,对我国医疗服务预算管理与卫生资源公平分配提供了参考。
In the process of achieving horizontal cooperation and vertical integration,China's medical service system needs to establish an effective fund allocation system and incentive mechanism to improve the service quality and efficiency of the medical service system.The US veterans medical system implements the reform process of adjusting the budget according to the head allocation budget and the factors such as the complexity of the disease and regional differences,and provides a reference for the budget management of medical services and the fair distribution of health resources in China.
In the process of achieving horizontal cooperation and vertical integration,China's medical service system needs to establish an effective fund allocation system and incentive mechanism to improve the service quality and efficiency of the medical service system.The US veterans medical system implements the reform process of adjusting the budget according to the head allocation budget and the factors such as the complexity of the disease and regional differences,and provides a reference for the budget management of medical services and the fair distribution of health resources in China.
引文
[1] U.S. DEPARTMENT OF VETERANS AFFAIRS. DEPARTMENT OF VETERANS AFFAIRS FY 2018-2024 STRATEGIC PLAN[EB/OL].[2018-08-28]. https://www.va.gov/oei/docs/VA2018-2024strategicPlan.pdf.
[2] U.S. DEPARTMENT OF VETERANS AFFAIRS.ABOUT VHA[EB/OL].[2018-08-28]. https://www.va.gov/health/aboutVHA.asp.
[3] U.S. DEPARTMENT OF VETERANS AFFAIRS. President Trump Seeks$12B Increase in FY2019 VA Budget to Support Nation's Veterans[EB/OL].(2018-02-12)[2018-11-08]. https://www.va.gov/budget/docs/summary/fy2019vasbudgetpressrelease.pdf.
[4] UNITED STATES GENERAL ACCOUNTING OFFICE.VA Health Care:Resource Allocation Methodology Has Had Little Impact on Medical Centers'Budgets, GAO/HRD-89-93, Aug 18, 1989[EB/OL].[2018-09-27]. https://www.gao.gov/products/HRD-89-93.
[5] UNITED STATES GENERAL ACCOUNTING OFFICE. VA Health care:more veterans are being served, but better oversight is needed[EB/OL].(1998-08-28)[2018-10-16]. https://www.gao.gov/products/HEHS-98-226.
[6] WASSERMAN J, RINGEL J S, WYNN B O, et al. An analysis of the Veterans Equitable Resource Allocation(VERA)System[EB/OL].[2018-10-16]. https://www.rand.org/pubs/monograph_reports/MR1419.html.
[7] WASSERMAN J, RINGEL J S,RICCI K A, et al. An analysis of potential adjustments to the Veterans Equitable Resource Allocation(VERA)System[EB/OL].[2018-10-16]. https://www.rand.org/pubs/monograph_reports/MR1629.html.
[8] WASSERMAN J, RINGEL J S,RICCI K A, et al. Understanding potential changes to the Veterans Equitable Resource Allocation(VERA)System[EB/OL].[2018-10-16]. https://www.rand.org/pubs/monographs/MG163.html.
[9] WASSERMAN J, RINGEL J S,RICCI K A, et al. Analyzing and influencing:how the VA allocates its health care dollars[EB/OL].[2018-10-16]. https://www.rand.org/pubs/research_briefs/RB9065.html.
[10] PRICE R A, FARMER C M. VA health system generally delivers higher-quality care than other health providers[EB/OL].(2018-04-26)[2018-11-07].https://www.rand.org/news/press/2018/04/26.html.
(1)VHA最初把全美医疗系统分为22个大区,后来做了调整,2015财年为21个大区。
[2] U.S. DEPARTMENT OF VETERANS AFFAIRS.ABOUT VHA[EB/OL].[2018-08-28]. https://www.va.gov/health/aboutVHA.asp.
[3] U.S. DEPARTMENT OF VETERANS AFFAIRS. President Trump Seeks$12B Increase in FY2019 VA Budget to Support Nation's Veterans[EB/OL].(2018-02-12)[2018-11-08]. https://www.va.gov/budget/docs/summary/fy2019vasbudgetpressrelease.pdf.
[4] UNITED STATES GENERAL ACCOUNTING OFFICE.VA Health Care:Resource Allocation Methodology Has Had Little Impact on Medical Centers'Budgets, GAO/HRD-89-93, Aug 18, 1989[EB/OL].[2018-09-27]. https://www.gao.gov/products/HRD-89-93.
[5] UNITED STATES GENERAL ACCOUNTING OFFICE. VA Health care:more veterans are being served, but better oversight is needed[EB/OL].(1998-08-28)[2018-10-16]. https://www.gao.gov/products/HEHS-98-226.
[6] WASSERMAN J, RINGEL J S, WYNN B O, et al. An analysis of the Veterans Equitable Resource Allocation(VERA)System[EB/OL].[2018-10-16]. https://www.rand.org/pubs/monograph_reports/MR1419.html.
[7] WASSERMAN J, RINGEL J S,RICCI K A, et al. An analysis of potential adjustments to the Veterans Equitable Resource Allocation(VERA)System[EB/OL].[2018-10-16]. https://www.rand.org/pubs/monograph_reports/MR1629.html.
[8] WASSERMAN J, RINGEL J S,RICCI K A, et al. Understanding potential changes to the Veterans Equitable Resource Allocation(VERA)System[EB/OL].[2018-10-16]. https://www.rand.org/pubs/monographs/MG163.html.
[9] WASSERMAN J, RINGEL J S,RICCI K A, et al. Analyzing and influencing:how the VA allocates its health care dollars[EB/OL].[2018-10-16]. https://www.rand.org/pubs/research_briefs/RB9065.html.
[10] PRICE R A, FARMER C M. VA health system generally delivers higher-quality care than other health providers[EB/OL].(2018-04-26)[2018-11-07].https://www.rand.org/news/press/2018/04/26.html.
(1)VHA最初把全美医疗系统分为22个大区,后来做了调整,2015财年为21个大区。