1995 Volume 2 Pages 5-16
Although there have been criticisms concerning the excessive use of drugs and laboratory tests, a nalysis of the 1987 to 1991 national claims data, mainly in ambulatory care, shows that this is mostly due to the diffusion of technology. The number of laboratory tests performed per claim was greater if the hospital was larger, in the public-sector, or attached to an university. For imaging, the number of CAT scans performed increased with some decreases in X -rays using contrast medium and specialized techniques. For drugs, there was a general tendency to use newer and more expensive drugs by all providers. To realize greater efficiency in the health care system, the following reforms should be considered: a hospital specific inclusive per-diem rate of payment linked to pre-determined performance indicators for public-sector hospitals, and the developement of an inclusive payment system for drugs together with more rigorous methods of evaluation.
