美国医疗保健制度规定------管理式医疗护理[外文翻译].doc

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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"planswillproducedemonstrablesavingsascomparedwiththecurrentcosttrendsoftraditionalfee-for-serviceme

2、dicine.Theyareacceleratingtheireffortstopromoteplansthatintegratethedeliveryandfinancingofcareandthatapplynewconstraintsonencountersbetweenphysiciansandpatients.Thekeyconstraintfordoctorsisthelimitationplacedontheautonomyoftheirclinicaldecisions.Theconstraintforpatientsistherequirementthattheys

3、eeonlyphysicianswhoaremembersofaplan'sclosedorpartiallyopenpanelorwhoareselectedas"preferred"practitioners.Ingeneral,thesedoctorshaveagreedtodeliveronly"necessary"medicalservicesinreturnforprescribedfees.Mostdefinitionscharacterizemanagedcareasasystemthatintegratesthefinancinganddeliveryofappro

4、priatemedicalcarebymeansofthefollowingfeatures:contractswithselectedphysiciansandhospitalsthatfurnishacomprehensivesetofhealthcareservicestoenrolledmembers,usuallyforapredeterminedmonthlypremium;utilizationandqualitycontrolsthatcontractingprovidersagreetoaccept;financialincentivesforpatientstou

5、setheprovidersandfacilitiesassociatedwiththeplan;andtheassumptionofsomefinancialriskbydoctors,thusfundamentallyalteringtheirrolefromservingasagentforthepatient'swelfaretobalancingthepatient'sneedsagainsttheneedforcostcontrol—or,asMechanicputitsuccinctly,moving"fromadvocacytoallocation."Becauset

6、hesefeaturescircumscribethefreedomofphysicianstopracticemedicineautonomously,theyreceivedecidedlymixedreviewsfromdoctors.Nevertheless,atleasthalfofallpracticingphysicianshavebecomeinvolvedinatleastonemanagedcarearrangement,andtheyhaveacceptedthetrade-offoflowerfeesforaguaranteedflowofpatients.T

7、herealityisthatthisnewmodelhasrapidlyemergedasadominantoneintheAmericanhealthcaresystem.Atthesametimeasthesenewnetworksaredeveloping,someexistinglargemultispecialtygrouppracticesthatpreviouslytreatedpatientsonlyonatraditionalfee-f