Feldman R, Chan H C, Kralewski J, Dowd B, Shapiro J
University of Minnesota, Minneapolis, MN 59455.
J Health Econ. 1990 Sep;9(2):207-22. doi: 10.1016/0167-6296(90)90018-x.
Why do health maintenance organizations (HMOs) use particular hospitals, and do they concentrate patients in hospitals where they obtain low prices? We answered these questions with a study of six HMOs in four large metropolitan areas in 1986. A two-part model was estimated for the probability that a hospital would be used and the demand for general inpatient admissions at hospitals that were used. Four staff-network plans in our study do shop for hospital services on the basis of price more than was generally believed. However, two independent practice association (IPAs) plans use more hospitals in the community and do not concentrate patients effectively at hospitals that offer the lowest prices.
为什么健康维护组织（HMOs）会选择特定的医院，它们是否会将患者集中在能获得低价的医院呢？我们通过对1986年四个大城市地区的六个健康维护组织进行研究来回答这些问题。针对医院被选用的概率以及被选用医院的普通住院床位需求，我们估计了一个两部分模型。我们研究中的四个员工网络计划确实会比普遍认为的更基于价格来挑选医院服务。然而，两个独立执业协会（IPA）计划使用社区内更多的医院，并且没有有效地将患者集中在提供最低价格的医院。
