Fossett J W, Choi C H, Peterson J A
Graduate School of Public Affairs, State University of New York, Albany.
Med Care. 1991 Oct;29(10):964-76. doi: 10.1097/00005650-199110000-00003.
This article examines the relationship between the use of hospital outpatient services by Medicaid patients, Medicaid physician fees, and the use of office-based physician services. Past research has indicated that the use of outpatient facilities by Medicaid patients substitutes for care by private physicians and might be reduced by raising physician fees, but these studies may be estimated at too high a level of geographic aggregation and include many outpatient services that are not substitutes for office-based physician care. The results in this study, which are estimated using LISREL on county level Medicaid claims data from the state of Illinois, provide little evidence that outpatient care substitutes for care by physicians or that raising physician fees would reduce inappropriate outpatient usage by medicaid patients.
本文探讨了医疗补助计划患者使用医院门诊服务、医疗补助计划医生诊疗费以及使用门诊医生服务之间的关系。以往研究表明，医疗补助计划患者使用门诊设施可替代私人医生的诊疗服务，提高医生诊疗费可能会减少这种使用，但这些研究的地理聚合水平估计过高，且纳入了许多并非替代门诊医生诊疗服务的门诊服务。本研究使用LISREL软件对伊利诺伊州县级医疗补助计划索赔数据进行估计，结果几乎没有证据表明门诊医疗可替代医生诊疗服务，也没有证据表明提高医生诊疗费会减少医疗补助计划患者不适当的门诊使用情况。
