However, as of 2008 these initiatives have only included hospitals that are self-insured and that employ their staffs, thus limiting the number of parties involved.
然而，截至2008年，這些首倡活動之中僅僅包括的是那些自我投保的醫院和自己雇傭工作人員的醫院，因而限制了參與方的數量。