Department of Healthcare Policy and Research, Weill Cornell Medical College, New York, NY.
Department of Health Management and Policy, University of Michigan School of Public Health, Ann Arbor, MI.
Health Serv Res. 2018 Aug;53(4):2133-2146. doi: 10.1111/1475-6773.12765. Epub 2017 Sep 21.
To examine the relationship of physician versus hospital ownership of small- and medium-sized practices with spending and utilization of care.
DATA SOURCE/STUDY SETTING/DATA COLLECTION: Survey data for 1,045 primary care-based practices of 1-19 physicians linked to Medicare claims data for 2008 for 282,372 beneficiaries attributed to the 3,010 physicians in these practices.
We used generalized linear models to estimate the associations between practice characteristics and outcomes (emergency department visits, index admissions, readmissions, and spending).
Beneficiaries linked to hospital-owned practices had 7.3 percent more emergency department visits and 6.4 percent higher total spending compared to beneficiaries linked to physician-owned practices.
Physician practices are increasingly being purchased by hospitals. This may result in higher total spending on care.
研究小型和中型实践中医生与医院所有权与医疗保健支出和利用之间的关系。
数据来源/研究环境/数据收集:2008 年,对隶属于 1 至 19 名医生的 1045 个以初级保健为基础的实践进行了调查,并将这些实践与 Medicare 索赔数据相关联,这些数据涉及 282372 名受益人与这些实践中的 3010 名医生有关。
我们使用广义线性模型来估计实践特征与结果(急诊就诊、指数入院、再入院和支出)之间的关联。
与医生所有的实践相关联的受益人比与医院所有的实践相关联的受益人急诊就诊多 7.3%,总支出高 6.4%。
医生实践越来越多地被医院收购。这可能导致医疗保健总支出增加。