Blumenthal D, Rizzo J A
Brigham and Women's Hospital, Boston, MA 02115.
Med Care. 1991 Jun;29(6):502-20.
Physician involvement with uninsured patients is a topic of increasing policy interest. In the past, data limitations have hindered analysis of factors influencing physician contact with uninsured patients. This article attempts to bridge this gap in the health services research literature. Using a nationally representative sample of nonfederal patient care physicians, the study revealed marked variations in physician involvement with uninsured patients by specialty class, employment status, and other practice characteristics. Pediatricians and general practitioners had roughly comparable involvement with uninsured patients, while internists and surgeons were significantly less involved. Self-employed physicians generally participated less in caring for uninsured patients than did employed physicians. While definitive evidence that people without coverage face serious access problems is not provided, such a conclusion is certainly consistent with the results of this study. Indeed, the proportion of the average physician's patients who are uninsured is substantially below current estimates of the proportion of the general population that is uninsured.
医生与未参保患者的接触是一个日益受到政策关注的话题。过去，数据限制阻碍了对影响医生与未参保患者接触的因素的分析。本文试图填补卫生服务研究文献中的这一空白。该研究使用了一个具有全国代表性的非联邦患者护理医生样本，结果显示，医生与未参保患者的接触程度因专业类别、就业状况和其他执业特征而存在显著差异。儿科医生和全科医生与未参保患者的接触程度大致相当，而内科医生和外科医生的接触程度则明显较低。个体执业医生通常比受雇医生更少参与照顾未参保患者。虽然没有提供确凿证据表明未参保人群面临严重的就医问题，但这样的结论肯定与本研究的结果一致。事实上，普通医生的患者中未参保者的比例大大低于目前对未参保总人口比例的估计。
