Kwon I W, Stoeberl P A, Martin D, Bae M
Saint Louis University, MO, USA.
Health Serv Manage Res. 1999 Feb;12(1):15-24. doi: 10.1177/095148489901200102.
Although the issue of uncompensated care (bad debt plus charity care) has been actively debated in the public arena, there has been little discussion of the bad debt issue alone. This issue is important since issues of bad debt, charity care and uncompensated care are significantly different from each other. Based on 1992 State of Missouri data, the results of our study indicate that more efficient hospitals (measured by occupancy rate), hospitals with more patients covered by prospective payment systems (measured by Medicare discharges), and for-profit hospitals incurred significantly less bad debt cost than other hospitals. However, the difference in bad debt between for-profit hospitals and not-for-profit hospitals is dissipated when using a multivariate statistical model. In addition, this study also reveals that hospitals which provide more charity care have the lowest bad debt costs. Policy implications are also discussed.
尽管未补偿医疗（坏账加慈善医疗）问题在公共领域一直受到热烈讨论，但单独关于坏账问题的讨论却很少。这个问题很重要，因为坏账、慈善医疗和未补偿医疗问题彼此有显著差异。基于1992年密苏里州的数据，我们的研究结果表明，效率更高的医院（以入住率衡量）、有更多患者被前瞻性支付系统覆盖的医院（以医疗保险出院人数衡量）以及营利性医院产生的坏账成本明显低于其他医院。然而，在使用多元统计模型时，营利性医院和非营利性医院之间的坏账差异就消失了。此外，这项研究还表明，提供更多慈善医疗的医院坏账成本最低。本文还讨论了政策影响。
