Kilpatrick K E, Miller M K, Dwyer J W, Nissen D
Department of Health Policy and Administration, School of Public Health, University of North Carolina, Chapel Hill 27599-7400.
Health Serv Res. 1991 Aug;26(3):277-302.
While a great deal of attention has been paid in recent years to establishing the magnitude and characteristics of uncompensated care in hospitals, comparatively little research has been undertaken to study physician uncompensated care. This article reports the results of a prospective patient-specific study of uncompensated care in Florida. Of 4,042 cases examined, 26.2 percent had charges voluntarily reduced below the usual and customary charge at the time of service. However, only 13.5 percent of those reductions were attributed to charity. Overall, 10.4 percent of the total billed amount was left unresolved. When payment source was considered, it was found that self-pay patients accounted for 30.6 percent of the cases but accounted for 52.0 percent of the unresolved amounts. Further analysis indicated that the self-pay patients were 35.5 times more likely to leave an outstanding balance than individuals with some type of insurance coverage. Odds of unresolved balances were also calculated as a function of income, specialty type, practice size, and type of visit.
近年来,虽然人们对确定医院未补偿医疗的规模和特征给予了大量关注,但对医生未补偿医疗的研究相对较少。本文报告了一项针对佛罗里达州未补偿医疗的前瞻性特定患者研究结果。在检查的4042个病例中,26.2%的病例在服务时收费被自愿降低至低于通常和惯例收费。然而,这些降低中只有13.5%归因于慈善。总体而言,总账单金额的10.4%未得到解决。在考虑支付来源时,发现自费患者占病例的30.6%,但占未解决金额的52.0%。进一步分析表明,自费患者留下未付余额的可能性是有某种保险覆盖的个人的35.5倍。未解决余额的几率也作为收入、专业类型、诊所规模和就诊类型的函数进行了计算。