Decker Sandra L
National Center for Health Statistics, 3311 Toledo Road, Room 3316, Hyattsville, MD 20782, USA.
Inquiry. 2009 Fall;46(3):291-304. doi: 10.5034/inquiryjrnl_46.03.291.
Controlling for state fixed effects and other factors, this paper estimates the effect of the generosity of Medicaid physician payment levels on the volume and site of ambulatory care received by Medicaid patients compared to privately insured patients. Results indicate that cuts in Medicaid physician fees lead to statistically significant reductions in the number of visits for Medicaid patients compared to privately insured patients. Cuts in fees also lead to a statistically significant shift away from physician offices and toward hospital emergency departments and especially outpatient departments. Primary diagnoses for which site of care shifts are most pronounced include hypertension, asthma, urinary tract infections, and diabetes.
在控制州固定效应和其他因素的情况下，本文估计了与私人保险患者相比，医疗补助计划医生支付水平的慷慨程度对医疗补助计划患者接受门诊护理的数量和地点的影响。结果表明，与私人保险患者相比，医疗补助计划医生费用的削减导致医疗补助计划患者就诊次数在统计上显著减少。费用削减还导致从医生办公室显著转向医院急诊科，尤其是门诊部。护理地点转移最明显的主要诊断包括高血压、哮喘、尿路感染和糖尿病。
