Barro Jason R, Huckman Robert S, Kessler Daniel P
Bain and Company, USA.
J Health Econ. 2006 Jul;25(4):702-21. doi: 10.1016/j.jhealeco.2005.11.001. Epub 2005 Dec 6.
The recent rise of specialty hospitals--typically for-profit firms that are at least partially owned by physicians--has led to substantial debate about their effects on the cost and quality of care. Advocates of specialty hospitals claim they improve quality and lower cost; critics contend they concentrate on providing profitable procedures and attracting relatively healthy patients, leaving (predominantly nonprofit) general hospitals with a less-remunerative, sicker patient population. We find support for both sides of this debate. Markets experiencing entry by a cardiac specialty hospital have lower spending for cardiac care without significantly worse clinical outcomes. In markets with a specialty hospital, however, specialty hospitals tend to attract healthier patients and provide higher levels of intensive procedures than general hospitals.
专科医院（通常是由医生至少部分持股的营利性公司）近来的兴起引发了关于其对医疗成本和质量影响的大量争论。专科医院的支持者称它们提高了质量并降低了成本；批评者则认为它们专注于提供可盈利的医疗程序并吸引相对健康的患者，从而使（主要是非营利性的）综合医院面对的患者群体报酬更低、病情更重。我们发现这场争论的双方观点都有依据。有心脏专科医院进入的市场，心脏护理支出更低，同时临床结果并无显著恶化。然而，在有专科医院的市场中，专科医院往往会吸引更健康的患者，并且比综合医院提供更高水平的强化医疗程序。
