Brown H Shelton
UT School of Public Health, Brownsville RAHC, Texas 78520, USA.
Health Econ. 2003 Feb;12(2):149-58. doi: 10.1002/hec.712.
By focusing exclusively on consumer benefit, previous studies of the effects of managed care have ignored important hospital efficiency gains. This study uses the HCUP sample of hospitals for 1992-1996 to estimate a stochastic frontier model of hospital technical efficiency. After controlling for hospital and market area variables, the study finds strong evidence that increased managed care insurance in a given market is associated with improved technical efficiency in the area's hospitals, especially in tertiary cases. Using Battese and Coelli's one-stage method (1995), the coefficients estimates are more efficient than for two-stage methods found in the literature.
以往关于管理式医疗效果的研究仅关注消费者利益，而忽略了医院效率的重要提升。本研究使用1992 - 1996年医疗成本和利用项目（HCUP）的医院样本，来估计医院技术效率的随机前沿模型。在控制了医院和市场区域变量后，该研究发现有力证据表明，特定市场中管理式医疗保险的增加与该地区医院技术效率的提高相关，尤其是在三级医疗病例中。使用巴特西和科埃利1995年的一步法，系数估计比文献中发现的两步法更有效。
