Thorpe K E, Phelps C E
Harvard School of Public Health, Boston, MA 02115.
J Health Econ. 1990 Sep;9(2):143-66. doi: 10.1016/0167-6296(90)90015-u.
This article parameterizes and examines the regulatory intensity of New York's all-payer rate setting system. The model, using hospital level data, compares the effects of specific features of rate-setting designed to promote cost containment. Two indicators measuring regulatory intensity were examined; the extent of hospital-specific disallowances, and how frequently the base year was adjusted (the degree of prospectivity). The results indicate that both the degree of prospectivity and the extent of disallowances importantly affect cost growth. Hospitals, when constrained, primarily achieved cost savings through reductions in non-medical personnel.
本文对纽约全支付方费率设定系统的监管强度进行了参数化并加以考察。该模型利用医院层面的数据，比较了旨在促进成本控制的费率设定特定特征的影响。考察了两个衡量监管强度的指标；特定医院不允许列支的程度，以及基年调整的频率（前瞻性程度）。结果表明，前瞻性程度和不允许列支的程度都对成本增长有重要影响。医院在受到约束时，主要通过减少非医疗人员来实现成本节约。
