Zhang M
University of Arkansas for Medical Sciences, Little Rock 72205, USA.
Health Mark Q. 1995;12(3):71-83. doi: 10.1300/J026v12n03_08.
It has been observed that enrollees in managed care systems such as HMOs and PPOs have lower expenditures and utilization rates than those in conventional insurance plans. Few studies have investigated this issue by examining providers. This paper studies whether physicians with low costs are more likely to sign contracts with HMOs and PPOs in order to help explain the observation of lower expenditures and utilization rates by HMO and PPO enrollees. A logistic regression is applied to the data from the 1984-1985 Physician Practice Costs and Income Survey. The results do not show strong evidence that a physician's likelihood of contracting with HMOs and PPOs is related to the physician's practice costs and utilization pattern. Instead, major factors that significantly affect a physician's decision of contracting with managed care systems are the physician's socio-demographics, the physician's practice region, and the market conditions.
据观察,健康维护组织(HMO)和优先提供者组织(PPO)等管理式医疗系统的参保者比传统保险计划的参保者支出和使用率更低。很少有研究通过考察医疗服务提供者来调查这个问题。本文研究成本较低的医生是否更有可能与HMO和PPO签订合同,以帮助解释HMO和PPO参保者支出和使用率较低的现象。对1984 - 1985年医生执业成本与收入调查的数据进行了逻辑回归分析。结果并未显示出有力证据表明医生与HMO和PPO签订合同的可能性与医生的执业成本及使用模式有关。相反,显著影响医生与管理式医疗系统签订合同决策的主要因素是医生的社会人口统计学特征、医生的执业地区以及市场状况。