Mitchell J B, Cromwell J
J Health Econ. 1982 Dec;1(3):245-64. doi: 10.1016/0167-6296(82)90003-0.
Using a national sample of general practitioners, internists, and general surgeons, we analyzed the willingness of physicians to accept Medicare patients on assignment. Assignment rates were found to be very sensitive to reimbursement and administrative practices under Medicare. A ten percent increase in the prevailing charge, for example, raised assignment by 14.7 percent. The assigned and non-assigned components of the Medicare program were found to compete with each other; assignment rates were lower where the demand for non-assigned services was stronger. As for the kinds of physicians who take assignment, they were disproportionately general surgeons and foreign medical graduates.
我们使用了一个由全科医生、内科医生和普通外科医生组成的全国性样本,分析了医生接受医疗保险患者进行指派服务的意愿。研究发现,指派率对医疗保险下的报销和行政实践非常敏感。例如,现行收费提高10%,会使指派率提高14.7%。医疗保险计划的指派服务和非指派服务部分被发现相互竞争;在对非指派服务需求较强的地方,指派率较低。至于接受指派的医生类型,普通外科医生和外国医学毕业生的占比过高。