面向结果的报销政策对诊所、患者和制药公司影响的建模分析

Modeling the Impact of an Outcome-Oriented Reimbursement Policy on Clinic, Patients, and Pharmaceutical Firms

Management Science · 2000
被引 54
人大 A+FT50UTD24ABS 4*

中文导读

建立数学模型,分析美国联邦政府及健康维护组织推行的药品报销政策对患者福利、诊所利润和制药公司利润的联合影响,并利用诊所数据验证模型假设与结果。

Abstract

Tackling the steep increase in drug costs is an especially important issue among many health care providers and insurers. To entice the clinics to become more cost efficient, the U.S. federal government, as well as many HMOs, have developed various cost containment initiatives recently. However, the impact of these initiatives on the patients' well-being, the clinic's profitability, and the pharmaceutical firm's profitability has not been formally analyzed. In this paper we develop a mathematical model that is intended to examine the impact of a reimbursement policy for drug usage. Despite the simplistic structure of our model, the analysis enhances our understanding of the joint impact of the reimbursement policy on the patients, the clinic, and the pharmaceutical firm. Thus, our analysis can provide valuable information for evaluating the effectiveness of implementing such a reimbursement policy. In addition, we utilize the data gathered from a clinic to help support the assumptions and results of the underlying model.

药品报销政策诊所盈利患者福利制药企业利润