Hamilton V
Department of Medicine, McGill University, Montreal, Quebec, Canada.
Nonprofit Manag Leadersh. 1994 Summer;4(4):415-30. doi: 10.1002/nml.4130040405.
This article examines differential responses to the Medicare hospice benefit across ownership types. The analysis reveals little difference in costs or quality of service among government-owned, for-profit, and nonprofit hospices. However, there are significant differences in the numbers of patients served by ownership status. The results are consistent with the hypothesis that nonprofit hospices are patient maximizers, not profit maximizers in disguise who are aiming to circumvent the nondistribution constraint. A comparison of these results with those in the hospital and nursing home industries leads to the conclusion that Medicare regulations and the predominance of Medicare revenues in an industry induce similar outcomes in cost and quality across ownership types.
本文研究了不同所有制类型的临终关怀机构对医疗保险临终关怀福利的差异反应。分析表明,政府所有、营利性和非营利性临终关怀机构在成本或服务质量方面差异不大。然而,按所有制状况划分,服务患者的数量存在显著差异。这些结果与非营利性临终关怀机构是患者最大化者而非伪装的利润最大化者(旨在规避非分配约束)这一假设一致。将这些结果与医院和养老院行业的结果进行比较后得出结论,医疗保险法规以及一个行业中医疗保险收入的主导地位会导致不同所有制类型在成本和质量方面产生类似的结果。