Austin Daniel R, Baker Laurence C
Daniel R. Austin is a graduate of the School of Medicine at Stanford University and a resident physician at the University of California, San Francisco.
Laurence C. Baker (
Health Aff (Millwood). 2015 Oct;34(10):1753-60. doi: 10.1377/hlthaff.2015.0412.
Concentration among physician groups has been steadily increasing, which may affect prices for physician services. We assessed the relationship in 2010 between physician competition and prices paid by private preferred provider organizations for fifteen common, high-cost procedures to understand whether higher concentration of physician practices and accompanying increased market power were associated with higher prices for services. Using county-level measures of the concentration of physician practices and county average prices, and statistically controlling for a range of other regional characteristics, we found that physician practice concentration and prices were significantly associated for twelve of the fifteen procedures we studied. For these procedures, counties with the highest average physician concentrations had prices 8-26 percent higher than prices in the lowest counties. We concluded that physician competition is frequently associated with prices. Policies that would influence physician practice organization should take this into consideration.
医生群体的集中度一直在稳步上升,这可能会影响医生服务的价格。我们评估了2010年医生竞争与私人优选医疗机构支付的十五种常见高成本医疗程序价格之间的关系,以了解医生执业集中度的提高以及随之而来的市场力量增强是否与服务价格上涨相关。利用县级层面的医生执业集中度指标和县级平均价格,并对一系列其他地区特征进行统计控制,我们发现,在我们研究的十五种医疗程序中,有十二种的医生执业集中度与价格显著相关。对于这些医疗程序,医生平均集中度最高的县的价格比最低的县高出8% - 26%。我们得出结论,医生竞争通常与价格相关。影响医生执业组织的政策应考虑到这一点。