美國發展管理式照護的經驗與啟示__臺灣人文及社會科學引文索引資料庫

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題名：	美國發展管理式照護的經驗與啟示
書刊名：	中華公共衛生雜誌
作者：	江東亮／胡德偉
作者(外文)：	Chiang, Tung-liang／Hu, Teh-wei
出版日期：	2000
卷期：	19:5
頁次：	頁340-355
主題關鍵詞：	管理式照護；醫療費用控制；醫療品質；醫療改革；Managed care；Health cost control；Quality of care；Health care reforms
原始連結：	連回原系統網址
相關次數：	被引用次數:期刊(3) 博士論文(0) 專書(0) 專書論文(0) 排除自我引用:3 共同引用:3 點閱:18

　　　　　美國發展管理式照護與其醫療費用不斷上漲息息相關。管理式照護的特色在於利用種種管理技術將保險財務風險與健康服務提供相互結合，基本上分為兩大類，即健康維護組織 (HMO) 和擇優特約組織 (PPO)。綜合實證研究結果，可以發現：不僅管理式照護的醫療費用顯著低於傳統論量計酬之健康保險，而且管理式照護市場佔率越高，則醫療費用的成長率越低，唯管理式照護的臨床醫療品質是否亞於傳統健康保險並無定論。本文以美國發展管理式照護經驗為借鏡，建議全民健保改制必須重視深化醫療提供者的財務風險分擔並以增進國民健康為首要目標，同時亦必須注意配套措施的健全以及保障人人有適當醫療保健服務。

以文找文

　　　　　The evolution of managed care in the United States has been attributed to the rapidly increasing of health care costs. Characterized as a collection of systems that integrate the financing and delivery of health care services, managed care organizations might be grouped into two major groups: health mantenance organizaton (HMO) and preferred provider organization (PPO). A literatural review of empirical studies indicates not only that managed care has lower health care costs than traditional fee-for-servic e health insurance, but also that higher market share of managed care is associated with a lower growth rate of health care costs. Further, there has no conclusive evidence that traditional fee-for-service health insurance provides either consistently better or consistently worse clinical quality of care than managed care. Based on US experiences on managed care, we recommend that the National Health Insurance reform in Taiwan should pay more attention to increasing the finacial-risk sharing of health care provider and put pursuing population health as the formost priority. Besides, the infrastructure for reforming the National Health Insurance should be well developed and the premise of health care for all should be underscored.

以文找文

期刊論文
1.	Hwang, J. S.、Tsauo, J. Y.、Wang, J. D.(1996)。Estimation of expected quality adjusted survival by cross-sectional survey。Statistics in Medicine，15(1)，93-102。
2.	Newhouse, J. P.、Manning, W. G.、Morris, C. N.(1981)。Some Interim Results from a Controlled Trial of Cost Sharing in Health Insurance。The New England Journal of Medicine，305(25)，1051-1057。
3.	Iglehart, J. K.(1992)。The American Health Care System: Managed Care。The New England Journal of Medicine，327，742-747。
4.	Robinson, J.、Luft, H.(1988)。Competition, Regulation, and Hospital Costs, 1982-1986。Journal of the American Medical Association，260，2676-2681。
5.	Zwanziger, J.、Melnick, G.。Can Managed Care Plans Control Health Care Costs。Health Affairs，15(2)，185-200。
6.	Bodenheimer, T.(1999)。The American Health Care System - The Movement for Improved Quality in Health Care。The New England Journal of Medicine，340(6)，488-492。
7.	Epstein, A. M.(1998)。Rolling down the runway: the challenges ahead for quality report cards。JAMA，279(21)，1691-1696。
8.	Melnick, G. A.、Zwanziger, J.(1988)。Hospital behavior under competition and cost-containment policies. The California experience, 1980 to 1985。Journal of the American Medical Association，260(18)，2669-2675。
9.	Hickson, G. B.、Altemeier, W. A.、Perrin, J. M.(1987)。Physician reimbursement by salary or fee-for-service: Effect on physician practice behavior in a randomized prospective study。Pediatrics，80(3)，344-350。
10.	Shortell, Stephen M.、Gillies, Robin R.、Anderson, David A.(1994)。The New World of Managed Care: Creating Organized Delivery Systems。Health Affairs，13(5)，46-64。
11.	Woolf, Steven H.、Grol, Richard、Hutchinson, Allen、Eccles, Martin、Grimshaw, Jeremy(1999)。Clinical guidelines: Potential benefits, limitations, and harms of clinical guidelines。British Medical Journal，318(7182)，527-530。
12.	Cheng, S. H.、Chiang, T. L.(1997)。The effect of universal health insurance on health care utilization in Taiwan: Results from a natural experiment。The Journal of the American Medical Association，278(2)，89-93。
13.	Liang, J.、Wu, S. C.、Krause, N. M.、Chiang, T. L.、Wu, H. Y.(1992)。The Structure of the Mental Health Inventory among Chinese in Taiwan。Medical Care，30(8)，659-676。
14.	Mayer, T. R.、Mayer, G. G.(1995)。HMOs: origins and development。NEJM，312，590-594。
15.	Blendon, R. J.、Taylor, H.(1989)。Views on Health Care: Public Opinion in Three Nations。Health Affairs，8(1)，149-157。
16.	吳淑瓊、江東亮、梁浙西(19930300)。Age Differences in the Structure of Self-Reported Physical Health。中華民國公共衛生學會雜誌，12(1)，10-25。延伸查詢
17.	Newhouse, J.、Schwartz, W. B.、Williams, A. P.、Witsberger, Christina(198508)。Are fee-for-service costs increasing faster than HMO costs?。Medical Care，23(8)，960-966。
18.	Miller, R. H.、Luft, H. S.(1994)。Managed care plan performance since 1980: a literature analysis。JAMA，271(19)，1512-1519。
19.	Eddy, D. M.(1998)。Performance measurement: Problems and solutions。Health Affairs，17(4)，7-25。
20.	Hellinger, F.(1995)。Selection Bias in HMOs and PPOs: A Review of the Evidence。Inquiry，32，135-142。
21.	Conrad, D. A.、Sales, A.、Liang, S. Y.(2002)。The Impact of Financial Incentives on Physician Productivity in Medical Groups。Health Services Research，37，885-906。
22.	Cheng, T. A.、Williams, P.(1986)。The Design and Development of A Screening Questionnaire (CHQ) for use In Community Studies of Mental Disorders in Taiwan。Psychological Medicine，16(2)，415-422。
23.	Bero, L. A.、Grilli, R.、Grimshaw, J. M.、Harvey, E.、Oxman, A. D.、Thomson, M. A.(1998)。Closing the Gap Between Research and Practice: An Overview of Systematic Reviews of Interventions to Promote the Implementation of Research Findings . The Cochrane Effective Practice and Organization of Care Review Group。British Medical Journal，317，465-468。
24.	Feldstein, P. J.、Wickizer, T. M.、Wheeler, J. R.(1998)。The Effects of Utilization Review Programs on Health Care Use and Expenditures。The New England Journal of Medicine，318(20)，1310-1314。
25.	Chiang, Tung Liang(1997)。Taiwan's 1995 health care reform。Health Policy，39(3)，225-239。
26.	Gruber, L.、Shaddle, M.(1988)。From movement to industry: the growth of HMOs。Health Aff(Millwood)，7(3)，192-208。
27.	Enthoven, A. C.(1993)。The history and principles of managed competition。Health Affairs，12(Suppl)，7-23。
28.	Bodenheimer, T.、Sullivan, K.(199804)。How large employers are shaping the health care marketplace?。N Engl J Med，338，1003-1007+1084-1087。
29.	Levit, K. R.、Lazenby, H. C.、Braden, B. R.、National Health Accounts Team(1998)。National health spending trends in 1996。Health Aff(Millwood)，17(1)，35-52。
30.	Cantor, J. C.、Barrand, N. L.、Desonia, R. A. et al.、Chen, Alan B.、Merrill, Jeffrey C.(1991)。Business leaders' view on American health care。Health Aff (Millwood)，10(1)，98-105。
31.	Weiner, J. P.、de Lissovoy, G.(1993)。Razing a tower of Babel: a taxonomy for managed care and health insurance plans。Journal of Health Politics，18(1)，75-103。
32.	Gold, M. ;、Nelson, L. ;、Lake, T. et al,、Berenson R.(1995)。Berenson R. Behind the survey: a critical assessment of how little is known about arrangements between managed care plans and physicians。Medical Care Research and Review，52，307-341。
33.	Gold, M.、Hurley, R.、Lake, T.、Nelson, L.、Berenson R.(19951221)。A national survey of the arrangements managed-care plans make with physicians。N Engl J Med，333(25)，1678-1683。
34.	Chernew, M. E.(1998)。Managed care, medical technology, and health care cost growth: a review of the evidence。Medical Care Research and Review，55，259-288。
35.	Miller, R. H.、Luft, H. S.(1997)。Does managed care lead to better or worse quality of care?。Health Aff(Millwood)，16(5)，7-25。
36.	Manning, W. G.、Leibowitz, A.、Goldberg, G. A.、Rogers W. H.、Newhouse J. P.(1984)。A controlled trial of the effect of a prepaid group practice on use of services。N Engl J Med，310(23)，1505-1510。
37.	Ginsburgr, P. B.、Pickreign, J. D.(1996)。Tracking health care costs。Health Aff(Millwood)，15，140-149。
38.	Feldman, R. B.、Bryan, D.(199110)。Must adverse selection cause premium spirals?。Journal of Health Economics，10(3)，350-357。
39.	Wholey, D.、Feldman, R.、Christianson, J. B.(1995)。The effect of market structure on HMO premiums。Journal of Health Economics，14，81-105。
40.	Wickizer, T. M.、Feldstein, P. J.(1995)。The impact of HMO competition on private health insurance premiums, 1985-1992。Inquiry，32，241-251。
41.	Baker, L. C.、Corts, K. S.(1996)。HMO penetration and the cost of health care: market discipline or market segmentation?。The American Economic Review，86，389-394。
42.	Gaskin, D. J.、Hadley, J.(1997)。The impact of HMO penetration on the rate of hospital cost inflation, 1985-1993。Inquiry，34，205-216。
43.	Melnick, G. A.、Zwanziger, J.(1995)。State health care expenditures under competition and regulation, 1980 through 1991。American Journal of Public Health，85，1391-1396。
44.	Baker, L. C.(1997)。The effect of HMOs on fee-for- service health care expenditures: evidence from Medicare。Journal of Health Economics，16，453-481。
45.	Baker, L. C.(1999)。Association of managed care market share and health expenditures for fee-for-service Medicare patients。Journal of the American Medical Association，281，432-437。
46.	Luft, H. S.(1978)。How do health-maintenance organizations achieve their ”savings” ? rhetoric and evidence。N Engl J Med，298，1336-1343。
47.	Greenfield, S.、Nelson, E. C.、Zubkoff, M.、Manning, W.、Kravitz, RL、Keller, A.、Tarlow, AR、Ware, JE Jr.(19920325)。Variations in resource utilization among medical specialties and systems of care: results from the medical outcomes study。Journal of the American Medical Association，267(12)，1624-1630。
48.	Clancy, C. M.、Hillner, B. E.(1989)。Physicians as gatekeepers: the impact of financial incentives。Archives of Internal Medicine，149，917-920。
49.	Rosenberg, S. N.、Allen, A. R.、Handte, J. S.、Jackson, T. C.、Leto, L.、Rodstein, B. M.、Stratton S. D.、Westfakk, G.、Yasser, R.(19951116)。Effect of utilization review in a fee-for-service health insurance plan。N Engl J Med，333(20)，1326-1330。
50.	Gold, M.(1999)。The changing US health care system: challenges for responsible public policy。Milbank Quarterly，77，3-37。
51.	Chemew, M.(1995)。The impact of non-EPA HMOs on the number of hospitals and hospital capacity。Inquiry，32，143-154。
52.	Escarce, J. J.、Polsky, D.、Wozniak, G. D.、Pauly, M. V.、Kletke P. R.(199811)。Health maintenance organization penetration and the practice location choices of new physicians: a study of large metropolitan areas in the United States。Med Care，36(11)，1555-1566。
53.	Robinson, J. C.(1999)。The future of managed care organization。Health Affairs，18，7-24。
54.	Corrigan, J. M.、Eden, J. S.、Gold, M. R.、Pickreign, J. D.(1997)。Trends toward a national health care marketplace。Inquiry，34(1)，11-28。
55.	Robinson, J. C.(1991)。HMO market penetration and hospital cost inflation in California。Journal of the American Medical Association，266，2719-2723。
56.	Zwanziger, J.、Melnick, G. A.、Bamezai, A.(1994)。Costs and price competition in California hospitals, 1980-1990。Health Aff (Millwood)，13(4)，118-126。
57.	Simon, C. J.、Born, P. H.(1996)。Physician earnings in a changing managed care environment。Health Aff (Millwood)，15，124-133。
58.	Kuttner, R.(1999)。The American health care system: Wall Street and health care。N Engl J Med，340，664-668。
59.	Eddy, D. M(1997)。Balancing cost and quality in fee-for-service versus managed care。Health Aff (Millwood)，16，162-173。
60.	Sullivan, K.(1999)。Managed care plan performance since 1980: another look at 2 literature reviews。American Journal of Public Health，89，1003-1008。
61.	Dudley, R. A.、Miller, R. H.、Korenbort, T. Y.、Luft, Harold S.(199812)。The impact of financial incentives on quality of health care。Milbank Quarterly，76(4)，649-686。
62.	Himmelstein, D. U.、Woolhandler, S.、Hellander, I.、Wolfe, S. M.(199907)。Quality of care in investor-owned vs not-for-profit HMOs。Journal of the American Medical Association，282(2)，159-163。
63.	Blumenthal, D.(1996)。Quality of care, part 1: quality of care--what is it?。N Engl J Med，335，891-894。
64.	Thompson, J. W.、Bost, J.、Ahmed, F.、Ingallsms, C. E.、Sennett, C.(199801)。The NCQA’s quality compass: evaluating managed care in the United States。Health Aff (Millwood)，17(1)，152-158。
65.	Blendon, R. J.、Brodie, M.、Benson, J. M. et al.、Altman, Drew E.、Levitt, Larry、Hoff, Tina、Hugick, Larry(1998)。Understanding the managed care backlash。Health Aff (Millwood)，17(4)，80-94。
66.	Angell, M.、Kassirer, J. P.(1996)。Quality and the medical marketplace--following elephants。N Engl J Med，335，883-885。
67.	Blumenthal, D.(1996)。Quality of care, part 4; the origins of the quality-of-care debate。N Engl J Med，335，1146-1149。
68.	Iglehart, J. K.(1996)。The National Committee for Quality Assurance。N Engl J Med，335，995-999。
69.	Epstein, R. S.、Sherwood, L. M.(1996)。From outcomes research to disease management: a guide for the perplexed。Annals of Internal Medicine，124，832-837。
70.	Grimshaw, J. M.、Russell, I. T.(1993)。Effect of clinical guidelines on medical practice: a systematic review of rigorous evaluation。Lancet，342，1317-1322。
71.	Chassin, M. R.(1998)。Is health care ready for six sigma quality?。Milbank Quarterly，76，565-591。
72.	Reinhardt, U. E.(1999)。‘Mangled competition’ and ‘managed whatever’。Health Aff (Millwood)，18，92-94。
73.	Ellwood, P. M.(1988)。Shattuck Lecture--outcomes management。N Engl J Med，318，1549-1556。
74.	Brook, R. H.(1997)。Managed care is not the problem, quality is。Journal of the American Medical Association，278，1612-1614。
75.	Kindig, D. A.(1998)。Purchasing population health: aligning financial incentives to improve health outcomes。Health Services Research，33，223-242。
76.	張睿詒、江東亮(1998)。風險校正：健康保險市場的效率與公平之關鍵。中華衛誌，17，373-380。延伸查詢
77.	Kuttner, R.(1999)。The American health care system: health insurance coverage。N Engl J Med，340，163-167。
78.	Kronick, R.、Gilmer, T.(1999)。Explaining the decline in health insurance coverage, 1979-1995。Health Aff (Millwood)，18，30-47。
79.	Cunningham, P. J.、Grossman, J. M.、St.R. F.、Lesser, Cara S.(1999)。Managed care and physicians’ provision of charity care。Journal of the American Medical Association，281(12)，1087-1092。
80.	Cunningham, P. J.(1999)。Pressures on safety net access: the level of managed care penetration and uninsurance rate in a community。Health Services Research，34(1 Pt 2)，255-270。

會議論文
1.	江東亮、張睿詒(199807)。全民健康保險改革的議題與方向。全國社會福利會議，行政院內政部 (會議日期: 1998年7月20日至7月21日)。台北：行政院內政部。延伸查詢
2.	Hu, T. W.、Hung, Y. Y.(1999)。Health care reforms in Taiwan and the U.S.: what we can learn from each other。Taipei International Conference on Health Economics, Academic Sinica，Taipei International Conference (會議日期: 19990325-0326)。Taipei：Academic Sinica。

圖書
1.	Streiner, D. L.、Norman, G. R.(1995)。Health measurement scales: A practical guide to their development and use。New York, NY：Oxford University Press。
2.	Bowiing, A.(1997)。Measuring health: A review of quality of life measurement scales。Bukingham：Open University Press。
3.	OECD(1995)。New Directions in Health Care Policy。Paris：OECD。
4.	HIAA(1998)。Source Book of Health Insurance Data, 1997/1998。Washington, DC：HIAA。
5.	Levitt, L.、Lundy, J.、Srinivasn, S.(1998)。Trends and Indicators in the Changing Marketplace。Menlo Park, CA：Kaiser Family Foundation。
6.	IOM(1996)。The Nation’s Physician Workforce: Options for Balancing Supply and Requirements。Washington, DC：National Academy Press。
7.	Robinson, R.、Steiner, A.(1998)。Managed Health Care。Buckingham：Open University Press。
8.	VHA, Inc.(1998)。Setting Foundations for the Millennium: An Assessment of the Health Care Environment in the United States。Irving, TX：VHA, Inc.。
9.	Luft, H. S.(1981)。Health Maintenance Organizations :Dimensions of Performance。New York, NY：John Wiley & Sons Inc.。

其他
1.	AAHP(199801)。Manag19980ed care facts。
2.	AAHP(1995-1996)。HMO and PPO Industry Profile。
3.	AMA。News release: Physicians vote to form national negotiating organization，http://www.ama-assn.org/meetings/ public/annual99/990623.htm， 1999/06/23。

圖書論文
1.	Kane, C. K.、Emmons, D. W.、Wozniak, G. D.(1998)。Physician managed care contracting。AMA. Socioeconomic Characteristics of Medical Practice 1997/98。Chicago, IL：American Medical Association。

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