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Can case-based payment contain healthcare costs? - A curious case from China - ScienceDirect
Source: sciencedirect.com
Article summary:
1. Case-based payment pilot in Tianjin, China decreased per-admission costs for certain case-mixes but increased per-admission spending for specific diseases due to high cost therapeutic regimes.
2. The program decreased length-of-stay and out-of-pocket costs but did not increase readmissions.
3. Patient selection and up-coding were found to be significant factors in the program's unintended impact on increasing healthcare costs. Lessons were drawn that proper incentive design is crucial for the success of case-based payment programs.
Article analysis:
该文章提出了一个关于中国医疗保健成本控制的案例，但是其存在一些潜在的偏见和不足之处。
首先，文章只针对特定疾病进行了分析，而没有考虑其他疾病的情况。这可能导致结论的片面性和不具有普适性。
其次，文章提到了医生选择年轻、低风险患者参与计划的现象，但并未深入探讨这种行为背后的原因和影响。这可能会导致读者对医生行为的误解和不公正评价。
此外，文章没有充分考虑到计划实施可能带来的风险和负面影响。例如，如果医生为了获得更高的报酬而过度治疗或滥用药物，则可能会增加患者负担和医保支出。
最后，文章没有平等地呈现双方观点，并且似乎倾向于支持传统费用服务模式。这可能会导致读者对案例评估结果产生怀疑，并且无法全面理解新模式带来的优势和挑战。
综上所述，该文章虽然提供了一个有趣的案例来探讨医疗保健成本控制问题，但是其存在一些潜在偏见和不足之处需要注意。