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社会经济地位与医生的治疗决策。

Socio-economic status and physicians' treatment decisions.

作者信息

Brekke Kurt R, Holmås Tor Helge, Monstad Karin, Straume Odd Rune

机构信息

Department of Economics, Norwegian School of Economics (NHH), Bergen, Norway.

Uni Rokkan Centre, Bergen, Norway.

出版信息

Health Econ. 2018 Mar;27(3):e77-e89. doi: 10.1002/hec.3621. Epub 2017 Dec 6.

Abstract

This paper studies the relationship between patients' socio-economic status and general practitioners' (GPs') service provision by exploiting administrative patient-level data with information on consultation length, medical tests, and fee payments for each visit in Norway over a 5-year period (2008-2012). To reduce patient heterogeneity, we limit the sample to a given condition, diabetes type II, that is treated almost exclusively in primary care. We estimate GP fixed-effect models and control for a wide set of patient characteristics. Our results show that, for each visit, patients with low education get shorter consultations but more medical tests, patients with low income get less of both, and patients with low education/income get less services in monetary terms. We also find that, during a year, patients with low education/income visit the GP more often and receive more services in monetary terms. Thus, GPs treat patients differently according to their socio-economic status, but we find no support for a social gradient.

摘要

本文利用挪威5年期间(2008 - 2012年)患者层面的行政数据,这些数据包含每次就诊的咨询时长、医学检查以及费用支付等信息,研究患者的社会经济地位与全科医生(GP)服务提供之间的关系。为减少患者异质性,我们将样本限制在几乎仅在初级保健中治疗的特定疾病——II型糖尿病。我们估计了全科医生固定效应模型,并控制了一系列广泛的患者特征。我们的结果表明,每次就诊时,低学历患者的咨询时间较短,但接受的医学检查更多;低收入患者两者都较少;低学历/低收入患者在货币价值上获得的服务较少。我们还发现,在一年中,低学历/低收入患者更频繁地拜访全科医生,并且在货币价值上接受更多服务。因此,全科医生根据患者的社会经济地位区别对待患者,但我们没有发现社会梯度的证据。

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