Nelson L M, Langwell K M, Brown R S
GHAA J. 1987;8(2):63-78.
Individuals who are able to enroll in an HMO and retain the physician-patient relationship they had developed under fee-for-service arrangements ("rollovers") may differ on average in health status and other characteristics from those who changed physicians to join an HMO ("switchers") and those who did not have a regular physician prior to joining. If such differences exist, they could have important implications for the relative performance of IPA-model HMOs, which tend to enroll significant numbers of rollovers, and staff model HMOs, which primarily enroll switchers and individuals without a regular physician. This study uses survey data on Medicare beneficiaries who enrolled in 17 HMOs under the Medicare competition demonstrations to compare rollovers to both switchers and enrollees who previously had no regular physician. The findings indicate that rollovers are very similar to each of the other categories of enrollees on demographic and socioeconomic characteristics as well as self-reported health status.
能够加入健康维护组织（HMO）并维持他们在按服务收费安排下建立的医患关系（“转接”）的个体，在健康状况和其他特征方面，平均而言可能与那些更换医生以加入HMO的个体（“转换者”）以及那些在加入之前没有固定医生的个体有所不同。如果存在这样的差异，它们可能对独立执业协会（IPA）模式的HMO（倾向于招收大量转接者）和员工模式的HMO（主要招收转换者和没有固定医生的个体）的相对表现产生重要影响。本研究使用了参加医疗保险竞争示范项目下17个HMO的医疗保险受益人的调查数据，将转接者与转换者以及之前没有固定医生的参保者进行比较。研究结果表明，转接者在人口统计学和社会经济特征以及自我报告的健康状况方面，与其他各类参保者非常相似。
