Chaudry Rosemary V, Brandon William P, Thompson Carolyn R, Clayton R Stephen, Schoeps Nancy B
Ohio Department of Job & Family Services, Columbus, Ohio, USA.
Qual Health Res. 2003 Jan;13(1):37-56. doi: 10.1177/1049732302239410.
The purpose of the study was to describe the experiences of primary care physicians caring for Medicaid recipients in a demonstration mandatory health maintenance organization (HMO) managed care program. The authors collected data through semistructured individual or focus group interviews with 14 physicians and through interviews with the chief executive officers of the three HMOs participating in the demonstration program. Interview questions, developed initially from a review of the literature, addressed physicians' experiences as primary care providers for Medicaid recipients under traditional fee-for-service and under managed care arrangements through the demonstration program. Four themes emerged: providers' hassles and burdens, the complex needs of Medicaid patients, improved access to care under managed care, and individual providers' disconnect from the processes of health policy implementation and program evaluation.
该研究的目的是描述在一个示范性强制健康维护组织（HMO）管理式医疗项目中，初级保健医生照料医疗补助受益人的经历。作者通过对14名医生进行半结构化的个人访谈或焦点小组访谈，以及对参与示范项目的三家HMO的首席执行官进行访谈来收集数据。访谈问题最初源于对文献的回顾，涉及医生在传统按服务收费模式下以及通过示范项目在管理式医疗安排下作为医疗补助受益人的初级保健提供者的经历。出现了四个主题：提供者的麻烦与负担、医疗补助患者的复杂需求、管理式医疗下更好的就医机会，以及个别提供者与健康政策实施和项目评估过程脱节。
