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December 1987 (Volume 65)
Sanford L. Weiner
James H. Maxwell
Harvey M. Sapolsky
Daniel L. Dunn
William C. Hsiao
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Diagnosis-related Groups (DRGs) offer hospitals financial incentives to improve efficiency. To be effective, DRGs require a realignment of management so that physicians’ use of resources can be disciplined by administrators. The constituency for altering power relationships within hospitals, however, is, at best, a weak one: administrators see their primary task as the protection of physicians’ clinical autonomy. Constraints imposed on hospitals by regulators can be accommodated by minor adjustments in behavior that ensure neither gains in efficiency nor changes in decision-making authority.
Author(s): Sanford L. Weiner; James H. Maxwell; Harvey M. Sapolsky; Daniel L. Dunn; William C. Hsiao
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Volume 65, Issue 4 (pages 463–487) Published in 1987
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The Milbank Quarterly’s multidisciplinary approach and commitment to applying the best empirical research to practical policymaking offers in-depth assessments of the social, economic, historical, legal, and ethical dimensions of health and health care policy.