美国卫生费用持续上涨的原因及控制措施

Reasons of Health Care Expenditure Rising Continually and Control Measures in United States.

目前美国的卫生费用基数庞大 ,1998年占 GDP的 14% ,造成卫生经费持续上涨的原因除通货膨胀外 ,还与以下因素有关 :第三方付费的方式、不完善的市场、新技术的应用、人口老龄化、卫生保健模式、多方付费系统、庞大的管理费用、防卫性医疗、浪费等。在美国控制医疗费用的措施包括政府行为和市场竞争机制两方面 ,比如 :资源配置许可制度、对外国医科毕业生的限制政策、采用 DRG付费方式、管理型保健医疗等。

Recently, the health care expenditure is a huge number in United States, which is 1.147 trillion (14.0 percent of the GDP) in 1998. There are many factors that cause so high expenditures. Beside of general inflation in the overall economy, there are third-party payment, imperfect market, application of new technology, the aging, and model of health care delivery, multi-party payment system, large management cost, defensive medical service and waste. The characteristic of cost-control in the United States is combination of government regulation and market-based competition, such as certification of need, entry limits policy for foreign medical graduates, DRG payment system, managed health care, and so on.