Gaumer G L, Poggio E, Sennett C
Health Care Financ Rev. 1987 Dec;Spec No(Suppl):17-27.
This article examines the relationship between the introduction of State prospective reimbursement (PR) programs and mortality rates for elective surgery. We study 15 such programs using a sample of about 40 percent of U.S. hospitals. We examine mortality data for 1974 to 1983 for these hospitals, selecting a 20-percent sample of all Medicare admissions for eight elective procedures. Indirect standardization (age, sex, procedure) was used to define mortality outcomes, and regression procedures were used to estimate PR effects that controlled for hospital, community, and other regulatory influences. Introduction of PR is found to be occasionally and inconsistently associated with increases in relative mortality.
本文探讨了国家预期报销（PR）计划的引入与择期手术死亡率之间的关系。我们使用约40%的美国医院样本研究了15个此类计划。我们研究了这些医院1974年至1983年的死亡率数据，从所有医疗保险入院病例中选取了20%的样本用于八种择期手术。采用间接标准化（年龄、性别、手术）来定义死亡率结果，并使用回归程序来估计控制了医院、社区和其他监管影响的PR效应。研究发现，PR的引入偶尔且不一致地与相对死亡率的增加相关。
