Ku L, Fisher D
Health Policy Institute, Boston University.
Health Serv Res. 1990 Apr;25(1 Pt 1):25-42.
This study analyzed physician attitudes toward a variety of health care cost-containment policies, based on a national survey of 500 practicing doctors in 1984. Reactions to 23 policies were simplified to nine common themes using factor analysis. Although there was great diversity in views, physicians generally favored policies that increased responsibilities or costs for patients and disfavored policies that decreased physicians' autonomy of practice. For most policies, practice characteristics (specialty; type of practice, e.g., solo or group, salaried or self-employed; membership in medical societies; or percent of time in direct patient care) were not significant determinants of attitudes. Physicians who were more "conservative" with respect to the health care system tended to favor policies that shifted cost to patients, while more "liberal" doctors were more supportive of using prepaid health care, reducing the intensity of care, or selecting efficient providers. Overall, this study indicates that physicians still place a high value on their professional autonomy.
本研究基于1984年对500名执业医生的全国性调查,分析了医生对各种医疗成本控制政策的态度。通过因子分析,将对23项政策的反应简化为9个常见主题。尽管观点存在很大差异,但医生普遍支持增加患者责任或成本的政策,而不支持减少医生执业自主权的政策。对于大多数政策而言,执业特征(专业;执业类型,如个体或团体、受薪或自雇;医学协会会员资格;或直接照顾患者的时间百分比)并非态度的重要决定因素。在医疗保健系统方面较为“保守”的医生倾向于支持将成本转嫁给患者的政策,而较为“开明”的医生则更支持使用预付医疗保健、降低护理强度或选择高效的医疗服务提供者。总体而言,本研究表明医生仍然高度重视他们的职业自主权。