Bradbury R C, Golec J H, Sterns F E
Clark University, MA.
Health Serv Manage Res. 1993 May;6(2):99-108. doi: 10.1177/095148489300600204.
This study examines the effect of Independent Practice Association (IPA) HMO membership on hospital total charges, ancillary charges and length of stay (LOS) for surgical patients. Intrahospital comparisons of IPA and traditional insurance patients are made after adjusting for surgical procedure, admission severity of illness, age, sex and year of admission. Our multiple regression model indicates that IPA patients undergoing 12 frequently occurring surgical procedures have lower resource use. Eight (80%) of the 10 study hospitals exhibit a negative IPA beta coefficient for total charges, ancillary charges and LOS. Five (50%) hospitals have statistically significant (p < 0.05) negative coefficients for total charges, while one (10%) hospital has a significant positive coefficient. IPA patients exhibit adjusted total charges that are 6% lower than traditional insurance, ancillary charges that are 4.3% lower, and LOS that is 10% shorter.
本研究探讨独立执业协会（IPA）健康维护组织（HMO）会员资格对手术患者医院总费用、辅助费用及住院时间（LOS）的影响。在对手术程序、入院时疾病严重程度、年龄、性别及入院年份进行调整后，对IPA患者与传统保险患者进行了院内比较。我们的多元回归模型表明，接受12种常见外科手术的IPA患者资源使用较低。10家研究医院中有8家（80%）在总费用、辅助费用和住院时间方面呈现IPA负β系数。5家（50%）医院的总费用系数在统计学上显著为负（p < 0.05），而1家（10%）医院的系数为显著正相关。IPA患者的调整后总费用比传统保险患者低6%，辅助费用低4.3%，住院时间短10%。
