Hsieh Hui-Min, Bazzoli Gloria J
Department of Public Health, Kaohsiung Medical University, No. 100 Shih-Chuan 1st Road, Kaohsiung, Taiwan 80708.
Inquiry. 2012 Fall;49(3):254-67. doi: 10.5034/inquiryjrnl_49.03.02.
This study examines the association between hospital uncompensated care and reductions in Medicaid Disproportionate Share Hospital (DSH) payments resulting from the 1997 Balanced Budget Act. We used data on California hospitals from 1996 to 2003 and employed two-stage least squares with a first-differencing model to control for potential feedback effects. Our findings suggest that nonprofit hospitals did reduce provision of uncompensated care in response to reductions in Medicaid DSH, but the response was inelastic in value. Policymakers need to continue to monitor uncompensated care as sources of support for indigent care change with the Patient Protection and Affordable Care Act (ACA).
本研究考察了医院无偿医疗服务与因1997年《平衡预算法案》导致的医疗补助比例失调医院（DSH）支付减少之间的关联。我们使用了1996年至2003年加利福尼亚州医院的数据，并采用一阶差分模型的两阶段最小二乘法来控制潜在的反馈效应。我们的研究结果表明，非营利性医院确实因医疗补助DSH的减少而减少了无偿医疗服务的提供，但这种反应在价值上缺乏弹性。随着《患者保护与平价医疗法案》（ACA）的实施，贫困医疗服务支持来源发生变化，政策制定者需要继续监测无偿医疗服务情况。
