卫生政策中的行政负担

P. Herd, D. Moynihan
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引用次数: 18

摘要

美国的医疗保健系统极其复杂,产生了一系列看似无穷无尽的官僚障碍,这些障碍使用户既昂贵又难以导航。我们将行政负担框架应用于卫生政策的三个特定方面:《平价医疗法案》(ACA)、医疗补助和医疗保险。这些应用程序更多的是说明性的,而不是确定性的,旨在证明行政负担在政策的实施过程中发挥着关键和未被充分重视的作用,有时是故意的。首先,负担是间接的——它们对我们的生活产生了影响,最明显的是在获得医疗保健方面。其次,行政负担是分配的:一些群体,如穷人,比其他群体负担更重。第三,负担是政治和行政选择的函数,通过政策设计和执行过程构建。
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Administrative Burdens in Health Policy
The US healthcare system is enormously complex, begetting a seemingly endless array of bureaucratic obstacles that make it both costly and difficult to navigate for users. We apply the administrative burden framework to three particular aspects of health policy: the Affordable Care Act (ACA), Medicaid, and Medicare. The applications are more illustrative than definitive, intended to demonstrate that administrative burdens play a key and underappreciated role in how policies are implemented, sometimes deliberately so. The following claims arise from our framework. First, burdens are consequential – they make a difference in our lives, most obviously in terms of access to healthcare. Second, administrative burdens are distributive: some groups, like the poor, are more burdened than others. Third, burdens are a function of political and administrative choices, constructed via processes of both policy design and implementation.
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来源期刊
Journal of health and human services administration
Journal of health and human services administration Nursing-Leadership and Management
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1.60
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期刊介绍: The Journal of Health and Human Services Administration (JHHSA) began publication in 1978 as the Journal of Health and Human Resources Administration. It is a blind-refereed journal dedicated to publishing articles, symposia and book reviews in all areas of health, hospital and welfare administration and management.
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