Virnig B A, Persily N A, Morgan R O, DeVito C A
University of Miami School of Medicine, FL, USA.
Hosp J. 1999;14(1):1-12. doi: 10.1080/0742-969x.1999.11882910.
This study compares use of the hospice benefit in Medicare fee-for-service (FFS) and Medicare risk-health maintenance organization (HMO) options in South Florida in 1992. A higher percentage of deaths occurred in hospice in the HMO option than in the FFS option. Compared to individuals in the FFS option, HMO-enrolled hospice users had longer lengths of hospice stay, lower 7-day mortality and higher 180-day (6 month) survival. These differences are consistent with the physician's financial incentives associated with the two programs.
本研究比较了1992年南佛罗里达州医疗保险按服务收费(FFS)模式和医疗保险风险健康维护组织(HMO)模式下临终关怀福利的使用情况。HMO模式下临终关怀机构中的死亡比例高于FFS模式。与FFS模式下的个体相比,参加HMO的临终关怀使用者的临终关怀住院时间更长,7天死亡率更低,180天(6个月)生存率更高。这些差异与两个项目中医生的经济激励措施一致。