Laditka James N
Arnold School of Public Health, University of South Carolina, Columbia 29208, USA.
Health Place. 2004 Sep;10(3):231-44. doi: 10.1016/j.healthplace.2003.09.004.
This study examines effects of physician supply and diversity on hospitalization for ambulatory care sensitive conditions (ACSH). Data are from 31 metropolitan areas in the 1984-1990 United States Longitudinal Study of Aging, and the Area Resource File. Discrete-time hazard models estimate ACSH risk. High ACSH risk may indicate problems with the accessibility or quality of primary care. Results show low supply areas have high risk. Adequate supply areas have significantly lower risk. Areas with greater supply have high risk, which may indicate supplier-induced hospitalization. Greater physician diversity reduces ACSH risk. Results support policies promoting physician placement in underserved areas, and those that educate minority physicians.
本研究考察了医生供给和多样性对门诊医疗敏感疾病(ACSH)住院治疗的影响。数据来自1984 - 1990年美国老龄化纵向研究中的31个大都市区以及区域资源文件。离散时间风险模型估计ACSH风险。高ACSH风险可能表明初级保健的可及性或质量存在问题。结果显示,供给不足地区风险高。供给充足地区风险显著较低。供给更多的地区风险高,这可能表明存在供方诱导住院现象。医生多样性越高,ACSH风险越低。研究结果支持促进医生到服务不足地区执业的政策,以及培养少数族裔医生的政策。