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本文引用的文献

1
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.
2
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.
3
Simulation of a health insurance market with adverse selection.具有逆向选择的健康保险市场模拟。
Oper Res. 1982 Nov-Dec;30(6):1027-42. doi: 10.1287/opre.30.6.1027.
4
Do health maintenance organizations work for Medicare?健康维护组织为医疗保险制度效力吗？
Health Care Financ Rev. 1993 Fall;15(1):7-23.
5
Disenrollment of Medicare beneficiaries from HMOs.医疗保险受益人退出健康维护组织。
Health Aff (Millwood). 1997 Sep-Oct;16(5):117-24. doi: 10.1377/hlthaff.16.5.117.
6
The Medicare-HMO revolving door--the healthy go in and the sick go out.医疗保险健康维护组织的旋转门——健康的人进去，生病的人出来。
N Engl J Med. 1997 Jul 17;337(3):169-75. doi: 10.1056/NEJM199707173370306.
7
Choice of payment plan in the Medicare capitation demonstration.医疗保险按人头付费示范项目中的支付计划选择
Med Care. 1986 Jul;24(7):628-40. doi: 10.1097/00005650-198607000-00006.
8
Biased selection and regression toward the mean in three Medicare HMO demonstrations: a survival analysis of enrollees and disenrollees.三项医疗保险健康维护组织示范项目中的偏向性选择与均值回归：参保者和退保者的生存分析
Med Care. 1989 Apr;27(4):337-51. doi: 10.1097/00005650-198904000-00002.
9
Enrollee health status under Medicare risk contracts: an analysis of mortality rates.医疗保险风险合同下参保人的健康状况：死亡率分析
Health Serv Res. 1991 Jun;26(2):137-63.
10
Selection bias in TEFRA at-risk HMOs.TEFRA风险健康维护组织中的选择偏倚。
Med Care. 1991 Apr;29(4):318-31. doi: 10.1097/00005650-199104000-00002.

医疗保险健康维护组织中的选择经历：参保前支出

Selection experiences in Medicare HMOs: pre-enrollment expenditures.

作者信息

Call K T, Dowd B, Feldman R, Maciejewski M

机构信息

University of Minnesota, USA.

出版信息

Health Care Financ Rev. 1999 Summer;20(4):197-209.

PMID:11482122
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4194606/
Abstract

Using 1993 and 1994 data, the authors examine whether beneficiaries who enroll in a Medicare health maintenance organization (HMO), including those enrolling for only a short period of time, have lower expenditures than continuous fee-for-service (FFS) beneficiaries the year prior to enrollment. We also test whether biased selection varies by the level of HMO market penetration and the rate of market-share growth. We find favorable selection associated with enrollment into Medicare HMOs, which declines as market share increases but does not disappear. Among short-term enrollees, we find unfavorable selection, however, selection bias was not sensitive to market characteristics.

摘要

作者利用1993年和1994年的数据，研究加入医疗保险健康维护组织（HMO）的受益人，包括那些仅短期参保的人，其支出是否低于参保前一年持续采用按服务付费（FFS）的受益人。我们还测试了选择偏差是否因HMO市场渗透率水平和市场份额增长率而异。我们发现加入医疗保险HMO存在有利选择，这种选择会随着市场份额的增加而下降，但不会消失。然而，在短期参保者中，我们发现了不利选择，不过选择偏差对市场特征并不敏感。