Lee A J, Mitchell J B
Health Economics Research, Inc., Waltham, MA 02154, USA.
Health Care Financ Rev. 1994 Winter;16(2):65-83.
Physicians may respond to fee reductions in a variety of ways. This episode-of-care analysis examines the impact of surgical fee reductions (mandated by the Omnibus Budget Reconciliation Acts [OBRAs] of 1986-87) on the overall pattern and cost of health care services provided in association with the surgical procedure itself. The study focuses on six procedure groups: cataract extractions; total hip replacement; total knee replacement; coronary artery bypass graft (CABG) surgery; upper gastrointestinal (GI) endoscopy; and prostatectomy. Only two of these procedures give significant evidence for the existence of a service volume offset to the fee reductions.
医生可能会以多种方式应对费用削减。这种按诊疗过程分析考察了手术费用削减（由1986 - 1987年的《综合预算协调法案》[OBRA]规定）对与手术本身相关的医疗服务总体模式和成本的影响。该研究聚焦于六个手术组：白内障摘除术；全髋关节置换术；全膝关节置换术；冠状动脉搭桥术（CABG）；上消化道（GI）内窥镜检查；以及前列腺切除术。在这些手术中，只有两种有显著证据表明存在服务量对费用削减的抵消情况。
