美国医疗保健制度------管理式医疗护理【外文翻译】

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1、本科毕业设计（论文）外文翻译原文TheAmericanHealthCareSystem—ManagedCareAmerica'sprivateandpublicthird-partypayers,squeezedbyhealthcarecoststhatcontinuetosoaratrateswellaboveinflation,arepersuadedthat"managedcare"planswillproducedemonstrablesavingsascomparedwiththecur

2、rentcosttrendsoftraditionalfee-for-servicemedicine.Theyareacceleratingtheireffortstopromoteplansthatintegratethedeliveryandfinancingofcareandthatapplynewconstraintsonencountersbetweenphysiciansandpatients.Thekeyconstraintfordoctorsisthelimitationplace

3、dontheautonomyoftheirclinicaldecisions.Theconstraintforpatientsistherequirementthattheyseeonlyphysicianswhoaremembersofaplan'sclosedorpartiallyopenpanelorwhoareselectedas"preferred"practitioners.Ingeneral,thesedoctorshaveagreedtodeliveronly"necessary"

4、medicalservicesinreturnforprescribedfees.Mostdefinitionscharacterizemanagedcareasasystemthatintegratesthefinancinganddeliveryofappropriatemedicalcarebymeansofthefollowingfeatures:contractswithselectedphysiciansandhospitalsthatfurnishacomprehensiveseto

5、fhealthcareservicestoenrolledmembers,usuallyforapredeterminedmonthlypremium;utilizationandqualitycontrolsthatcontractingprovidersagreetoaccept;financialincentivesforpatientstousetheprovidersandfacilitiesassociatedwiththeplan;andtheassumptionofsomefina

6、ncialriskbydoctors,thusfundamentallyalteringtheirrolefromservingasagentforthepatient'swelfaretobalancingthepatient'sneedsagainsttheneedforcostcontrol—or,asMechanicputitsuccinctly,moving"fromadvocacytoallocation."Becausethesefeaturescircumscribethefree

7、domofphysicianstopracticemedicineautonomously,theyreceivedecidedlymixedreviewsfromdoctors.Nevertheless,atleasthalfofallpracticingphysicianshavebecomeinvolvedinatleastonemanagedcarearrangement,andtheyhaveacceptedthetrade-offoflowerfeesforaguaranteedflo

8、wofpatients.TherealityisthatthisnewmodelhasrapidlyemergedasadominantoneintheAmericanhealthcaresystem.Atthesametimeasthesenewnetworksaredeveloping,someexistinglargemultispecialtygrouppracticesthatpreviouslytreatedpatientsonlyonatraditionalfee-f