Callison Kevin
Grand Valley State University, Grand Rapids, MI, USA.
Health Econ. 2016 Jul;25(7):873-87. doi: 10.1002/hec.3191. Epub 2015 May 11.
Evidence suggests that the share of Medicare managed care enrollees in a region affects the costs of treating traditional fee-for-service (FFS) Medicare beneficiaries; however, little is known about the mechanisms through which these 'spillover effects' operate. This paper examines the relationship between Medicare managed care penetration and treatment intensity for FFS enrollees hospitalized with a primary diagnosis of AMI. I find that increased Medicare managed care penetration is associated with a reduction in both the costs and the treatment intensity of FFS AMI patients. Specifically, as Medicare managed care penetration increases, FFS AMI patients are less likely to receive surgical reperfusion and mechanical ventilation and to experience an overall reduction in the number of inpatient procedures. Copyright © 2015 John Wiley & Sons, Ltd.
有证据表明，某地区医疗保险管理式医疗参保人的比例会影响传统按服务收费（FFS）医疗保险受益人的治疗成本；然而，对于这些“溢出效应”的作用机制，我们知之甚少。本文研究了医疗保险管理式医疗渗透率与以急性心肌梗死（AMI）为主诊断住院的FFS参保人的治疗强度之间的关系。我发现，医疗保险管理式医疗渗透率的提高与FFS AMI患者的成本和治疗强度降低有关。具体而言，随着医疗保险管理式医疗渗透率的提高，FFS AMI患者接受手术再灌注和机械通气的可能性降低，住院手术数量总体减少。版权所有© 2015约翰威立国际出版公司。
