Reductions in reimbursement are applied to all physicians in a region equally.
However, physicians do not practice in equivalent situations.
For example, there are few fiscal alphysicians do not practice in equivalent situations.
For example, there are few fiscal allowances for academic functions associated with teaching and administration.
Furthermore, university-based physicians may practice in clinical venues that cannot be as efficient as nonuniversity sites.
Unavoidable inefficiencies may include (1) the costs of maintaining one historical record for a large noncontiguous practice ; (2) university-required holiday schedules and sick leave, making university personnel less productive ; (3) noncompetitive overhead rates assigned to clinic components by university financial offices ; (4) university-based accounting systems that are not designed for effective cost control and the timely generation of useful management information ; and (5) poorly managed billing services.
Until now, declining reimbursements have generally led to sufficient efficiencies in delivery so that revenues and expenses can be in equilibrium.
Mots-clés Pascal : Economie santé, Etats Unis, Amérique du Nord, Amérique, Centre hospitalier universitaire, Coût, Rentabilité, Médecin
Mots-clés Pascal anglais : Health economy, United States, North America, America, Teaching hospital, Costs, Profitability, Physician
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0042935
Code Inist : 002B30A04B. Création : 17/04/1998.