财务欺诈、有针对性的联邦医疗保健资金与患者死亡率
Fiscal Shenanigans, Targeted Federal Health Care Funds, and Patient Mortality.
作者信息
Baicker Katherine, Staiger Douglas
机构信息
Dartmouth College and NBER.
出版信息
Q J Econ. 2005 Jan;120(1):345-386. doi: 10.1162/0033553053327461.
Abstract
We explore the effectiveness of matching grants when lower levels of government can expropriate some of the funds for other uses. Using data on the Medicaid Disproportionate Share program, we identify states that were most able to expropriate funds. Payments to public hospitals in these states were systematically diverted and had no significant impact on patient mortality. Payments that were not expropriated were associated with significant declines in patient mortality. Overall, subsidies were an effective mechanism for improving outcomes for the poor, but the impact was limited by the ability of state and local governments to divert the targeted funds.
摘要
当较低层级的政府能够挪用部分资金用于其他用途时，我们探究了配套补助的有效性。利用医疗补助中“比例失调份额”项目的数据，我们确定了那些最有能力挪用资金的州。这些州向公立医院的拨款被系统性地挪用，对患者死亡率没有显著影响。未被挪用的拨款与患者死亡率的显著下降相关。总体而言，补贴是改善穷人医疗结果的有效机制，但这一影响受到州和地方政府挪用目标资金能力的限制。
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