Davis A, Kerr C, Lloyd P, Taylor R, Waldby C
Department of Social Work and Social Policy, University of Sydney.
Aust Health Rev. 1991;14(4):450-68.
Utilising intensive semi-structured interviews with health professionals working in public hospitals in Sydney, a comparison was made of the perceived similarities and differences in the medical and administrative management of patients who were covered by Medicare and those who were privately insured. Interviewees argued that there was evidence of preferential access to public hospital care for privately insured patients due to medical misrepresentation of the urgency of their cases. They reported that some medical and administrative practices existed which compromised the choice of admission as a Medicare patient for those with private insurance, and for those without private insurance who were referred to hospital by a specialist. It was suggested also by the interviewees that medical considerations encouraged continuity of specialist care for Medicare patients admitted to hospital when they were known to an attending specialist. Such an allegation places in some doubt the claim made by private insurers that choice of doctor is permitted only under their cover. Interviewees did not report knowledge of any form of compromise in the quality of hospital care on the basis of medical preference for private patients. However, it was reported that private patients may, in some instances, be denied a full range of hospital services due to doctors' attempts to monopolise their treatment.
通过对悉尼公立医院的医护人员进行深入的半结构化访谈，比较了医疗保险覆盖患者和私人保险患者在医疗和行政管理方面的异同。受访者认为，有证据表明，由于对病情紧急程度的医疗误报，私人保险患者在公立医院获得优先治疗。他们报告说，存在一些医疗和行政做法，这些做法损害了有私人保险的患者以及由专科医生转诊到医院的无私人保险患者选择作为医疗保险患者入院的权利。受访者还指出，从医疗角度考虑，当主治专科医生认识住院的医疗保险患者时，会鼓励专科护理的连续性。这种说法让人对私人保险公司声称只有在其保险范围内才允许选择医生的说法产生了一些怀疑。受访者没有报告基于对私人患者的医疗偏好而导致医院护理质量出现任何形式妥协的情况。然而，据报告，在某些情况下，由于医生试图垄断治疗，私人患者可能会被拒绝提供全面的医院服务。
