Escarce J J
Department of Medicine, University of Pennsylvania, Philadelphia.
Inquiry. 1992 Winter;29(4):403-15.
This study uses Medicare enrollment and physician claims data to examine the effect of surgeon supply on the demand for surgeons' services. The specialties studied were ophthalmology, general surgery, orthopedic surgery, and urology. The study found that higher surgeon supply increases the demand for initial contacts with surgeons (first-occurrences demand) but does not affect the demand for services among surgeons' patients (intensity-of-care demand). These findings suggest that a high supply of surgeons improves access or is associated with stronger preferences for referrals to surgeons. The findings offer little support for the hypothesis that a substantial component of the additional utilization that occurs when surgeons are plentiful is due to increases in physician-induced demand.
本研究利用医疗保险参保数据和医生报销数据，考察外科医生供给对其服务需求的影响。所研究的专科领域包括眼科、普通外科、整形外科和泌尿外科。研究发现，外科医生供给增加会提高首次找外科医生看病的需求（初诊需求），但不影响外科医生现有患者的服务需求（医疗强度需求）。这些发现表明，外科医生供给充足能改善就医机会，或者与更倾向于转诊给外科医生有关。这些发现几乎无法支持以下假设：当外科医生数量充足时，额外医疗服务利用的很大一部分是由医生诱导需求的增加所致。
