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1
Selection bias in health maintenance organizations: analysis of recent evidence.健康维护组织中的选择偏倚:近期证据分析
Health Care Financ Rev. 1987 Winter;9(2):55-63.
2
Setting capitation payments in markets for health services.设定医疗服务市场中的人头费支付标准。
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3
Early experience of health maintenance organizations under Medicare competition demonstrations.医疗保险竞争示范项目下健康维护组织的早期经验。
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4
Beneficiary selection, use, and charges in two Medicare capitation demonstrations.两项医疗保险按人头付费示范项目中的受益人选派、使用情况及费用
Health Care Financ Rev. 1988 Fall;10(1):37-49.
5
Medicare reimbursement and regression to the mean.医疗保险报销与均值回归。
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Medicare capitation and quality of care for the frail elderly.医疗保险按人头付费与体弱老年人的医疗质量。
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Med Care Res Rev. 1999 Jun;56(2):177-96. doi: 10.1177/107755879905600204.
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Choice of payment plan in the Medicare capitation demonstration.医疗保险按人头付费示范项目中的支付计划选择
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10
Health care utilization in HMO's. Results from two national samples.健康维护组织(HMO)中的医疗保健利用情况。来自两个全国性样本的结果。
J Health Econ. 1985 Dec;4(4):293-308. doi: 10.1016/0167-6296(85)90010-4.

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Physician referrals of patients with neck and low back pain for physical therapy in outpatient clinics: a cross-sectional study.门诊诊所中颈部和下背部疼痛患者转介至物理治疗的情况:一项横断面研究。
Isr J Health Policy Res. 2025 Apr 3;14(1):20. doi: 10.1186/s13584-025-00683-7.
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3
ESRD managed care demonstration: financial implications.终末期肾病管理式医疗示范项目:财务影响
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4
Conducting research on the Medicare market: the need for better data and methods.对医疗保险市场进行研究:对更好的数据和方法的需求。
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Analysis of selection effects in New York City's Medicaid managed care population prior to mandatory enrollment.纽约市医疗补助管理式医疗人群在强制参保前的选择效应分析。
J Urban Health. 2000 Dec;77(4):625-44. doi: 10.1007/BF02344027.
6
Role of information in consumer selection of health plans.信息在消费者选择健康保险计划中的作用。
Health Care Financ Rev. 1996 Fall;18(1):31-54.
7
An analysis of selectivity bias in the Medicare AAPCC (adjusted average per capita cost).医疗保险AAPCC(调整后的人均成本)中的选择性偏差分析。
Health Care Financ Rev. 1996 Spring;17(3):35-57.
8
Selection in a preferred provider organization enrollment.在优选提供者组织注册中的选择。
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9
Health maintenance organizations, independent practice associations, and cesarean section rates.健康维护组织、独立执业协会与剖宫产率。
Health Serv Res. 1994 Apr;29(1):75-93.
10
Mental health care utilization in prepaid and fee-for-service plans among depressed patients in the Medical Outcomes Study.医疗结果研究中抑郁症患者在预付和按服务收费计划下的心理健康护理利用情况。
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本文引用的文献

1
Concerning high and low utilizers of service in a medical care plan, and the persistence of utilization levels over a three year period.关于医疗保健计划中服务的高使用者和低使用者,以及三年期间使用水平的持续性。
Milbank Mem Fund Q. 1959 Jul;37(3):217-50.
2
The effect of prior-year health expenditures on health coverage plan choice.上一年医疗支出对医保计划选择的影响。
Adv Health Econ Health Serv Res. 1985;6:149-70.
3
Pre-enrollment reimbursement patterns of Medicare beneficiaries enrolled in "at-risk" HMOs.参加“风险”健康维护组织(HMO)的医疗保险受益人的预注册报销模式。
Health Care Financ Rev. 1982 Sep;4(1):55-73.
4
Risk differential between Medicare beneficiaries enrolled and not enrolled in an HMO.参加和未参加健康维护组织(HMO)的医疗保险受益人的风险差异。
Health Care Financ Rev. 1980 Winter;1(3):91-9.
5
What is adverse about adverse selection?逆向选择的不利之处体现在哪些方面?
Adv Health Econ Health Serv Res. 1985;6:281-6.
6
Biased selection in Twin Cities health plans.双城医疗计划中的偏向性选择。
Adv Health Econ Health Serv Res. 1985;6:253-71.
7
Selectivity in the demand for health insurance and health care.健康保险和医疗保健需求中的选择性。
Adv Health Econ Health Serv Res. 1985;6:231-52.
8
Health care utilization in HMO's. Results from two national samples.健康维护组织(HMO)中的医疗保健利用情况。来自两个全国性样本的结果。
J Health Econ. 1985 Dec;4(4):293-308. doi: 10.1016/0167-6296(85)90010-4.
9
Health care costs in health maintenance organizations: correcting for self-selection.
Adv Health Econ Health Serv Res. 1984;5:95-128.
10
A controlled trial of the effect of a prepaid group practice on use of services.一项关于预付费团体医疗模式对服务使用影响的对照试验。
N Engl J Med. 1984 Jun 7;310(23):1505-10. doi: 10.1056/NEJM198406073102305.

健康维护组织中的选择偏倚:近期证据分析

Selection bias in health maintenance organizations: analysis of recent evidence.

作者信息

Hellinger F J

出版信息

Health Care Financ Rev. 1987 Winter;9(2):55-63.

PMID:10312393
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4192865/
Abstract

An analysis of recent research regarding selection bias in health maintenance organizations (HMO's) is presented in this article. Review of the available literature leads one to conclude that prepaid group practice HMO's do experience favorable selection. It has been demonstrated in numerous studies that prior use of health services by HMO enrollees is less than prior use of health services by those who remain in the fee-for-service sector, and there is considerable evidence that shows a statistically significant positive relationship between prior use and current use. This is true for both those under 65 years of age and those 65 years of age or over.

摘要

本文对近期有关健康维护组织(HMO)中选择偏倚的研究进行了分析。对现有文献的回顾使人们得出结论,预付团体医疗模式的健康维护组织确实存在有利选择。大量研究表明,健康维护组织参保者先前使用医疗服务的情况少于仍留在按服务收费部门的人,并且有大量证据表明,先前使用与当前使用之间存在统计学上显著的正相关关系。65岁以下人群和65岁及以上人群均是如此。