Buntin Melinda J Beeuwkes, Escarcé Jose J, Goldman Dana, Kan Hongjun, Laugesen Miriam J, Shekelle Paul
RAND, 1200 South Hayes St., Arlington, VA 22202, USA.
Inquiry. 2004 Spring;41(1):83-94. doi: 10.5034/inquiryjrnl_41.1.83.
In light of rising expenditures for physicians' services and the scheduled decreases in the amounts Medicare pays for such services, we identified the sources of change in the volume and intensity of Medicare physicians' services. We found that the per capita volume and intensity of physicians services used by Medicare beneficiaries increased more than 30% between 1993 and 1998. Our analyses indicated that, at most, half of this increase was due to measurable changes in the demographic composition, places of residence, prevalence of health conditions, and managed care enrollment of beneficiaries. The other half was due to a general increase in the use of care across beneficiary categories.
鉴于医生服务支出不断增加，以及医疗保险计划对这类服务支付金额的预定削减，我们确定了医疗保险医生服务量和服务强度变化的来源。我们发现，1993年至1998年间，医疗保险受益人群使用的医生服务人均量和服务强度增加了30%以上。我们的分析表明，这一增长最多只有一半是由于受益人的人口构成、居住地点、健康状况患病率和管理式医疗参保情况的可衡量变化。另一半则是由于各受益人群体对医疗服务使用的普遍增加。
