Mechanic D, Ettel T, Davis D
Rutgers University, Institute for Health, Health Care Policy and Aging Research, Brunswick, NJ 08903.
Inquiry. 1990 Spring;27(1):14-23.
This study examines how 296 new university employees selected among alternative health care options. Those selecting a traditional Blue Cross and Blue Shield (BC&BS) plan attributed greater importance to freedom of choice of physician, while those selecting an HMO were more likely to give priority to cost considerations in seeing a doctor and to having services at a single location. Better educated respondents and those with more recent experience with the medical care system were more accurate in objectively appraising alternative choices. Respondents, whether choosing a BC&BS plan or an HMO, tended to deny the gatekeeper roles of physicians in HMOs, although the BC&BS plan enrollees were somewhat better informed.
本研究调查了296名新入职大学员工如何在不同的医疗保健方案中进行选择。选择传统蓝十字蓝盾(BC&BS)计划的人更看重选择医生的自由,而选择健康维护组织(HMO)的人在看病时更倾向于优先考虑费用因素,并且希望在单一地点获得服务。受教育程度较高的受访者以及那些近期有过医疗系统就医经历的人,在客观评估替代选择时更为准确。无论选择BC&BS计划还是HMO的受访者,往往都否认健康维护组织中医生的把关人角色,尽管参加BC&BS计划的人了解的信息略多一些。