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.
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。
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本文引用的文献
1
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.
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