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"planswillproducedemonstrablesavingsascomparedwiththecurrentcost

2、trendsoftraditionalfee-for-servicemedicine.Theyareacceleratingtheireffortstopromoteplansthatintegratethedeliveryandfinancingofcareandthatapplynewconstraintsonencountersbetweenphysiciansandpatients.Thekeyconstraintfordoctorsisthelimitationplacedontheautonomyof

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

4、orprescribedfees.Mostdefinitionscharacterizemanagedcareasasystemthatintegratesthefinancinganddeliveryofappropriatemedicalcarebymeansofthefollowingfeatures:contractswithselectedphysiciansandhospitalsthatfurnishacomprehensivesetofhealthcareservicestoenrolledmem

5、bers,usuallyforapredeterminedmonthlypremium;utilizationandqualitycontrolsthatcontractingprovidersagreetoaccept;financialincentivesforpatientstousetheprovidersandfacilitiesassociatedwiththeplan;andtheassumptionofsomefinancialriskbydoctors,thusfundamentallyalte

6、ringtheirrolefromservingasagentforthepatient'swelfaretobalancingthepatient'sneedsagainsttheneedforcostcontrol—or,asMechanicputitsuccinctly,moving"fromadvocacytoallocation."Becausethesefeaturescircumscribethefreedomofphysicianstopracticemedicineautonomously,th

7、eyreceivedecidedlymixedreviewsfromdoctors.Nevertheless,atleasthalfofallpracticingphysicianshavebecomeinvolvedinatleastonemanagedcarearrangement,andtheyhaveacceptedthetrade-offoflowerfeesforaguaranteedflowofpatients.Therealityisthatthisnewmodelhasrapidlyemerge

8、dasadominantoneintheAmericanhealthcaresystem.Atthesametimeasthesenewnetworksaredeveloping,someexistinglargemultispecialtygrouppracticesthatpreviouslytreatedpatientsonlyonatraditionalfee-f