Lee Keon-Hyung
Askew School of Public Administration and Policy, The Florida State University, Tallahassee, FL 32306-2250, USA.
J Med Syst. 2007 Aug;31(4):254-62. doi: 10.1007/s10916-007-9063-2.
Hospital competition and managed care have negatively affected hospital profitability. In the current turbulent health care environment in the U.S., hospitals in California have argued that the rate of increase in hospital costs is faster than the rate of increase in hospital revenues. By employing Medicare case mix indexes (CMIs) as a primary policy variable, this study found that the coefficients for CMIs in hospital costs for Medicare patients were smaller than those in hospital revenues in the years of 1986, 1989 and 1998. However, the coefficients for CMIs in hospital costs for Medicare patients were greater than those in hospital revenues in the years of 1992 and 1995. Although there were some differences between the coefficients for CMIs in hospital costs and revenues for Medicare patients, those differences found to be statistically insignificant. In spite of claims on behalf of Californian hospitals, the rate of increase in hospital costs for Medicare patients had not been greater than that of hospital revenues for Medicare patients.
医院竞争和管理式医疗对医院盈利能力产生了负面影响。在美国当前动荡的医疗环境中，加利福尼亚州的医院认为，医院成本的增长速度快于医院收入的增长速度。通过将医疗保险病例组合指数（CMIs）作为主要政策变量，本研究发现，在1986年、1989年和1998年，医疗保险患者医院成本中CMIs的系数小于医院收入中的系数。然而，在1992年和1995年，医疗保险患者医院成本中CMIs的系数大于医院收入中的系数。尽管医疗保险患者医院成本和收入中CMIs的系数存在一些差异，但这些差异在统计上不显著。尽管有代表加利福尼亚州医院的说法，但医疗保险患者医院成本的增长速度并未高于医疗保险患者医院收入的增长速度。
