Brown E R, Cousineau M R, Price W T
Inquiry. 1985 Fall;22(3):237-50.
Although we cannot yet judge the broad consequences of Medi-Cal selective contracting, we can assess the outcome of the contracting process and the role that competition and other factors played in that process. In this study of the qualitative and quantitative characteristics of hospitals in Los Angeles County that bid for Medi-Cal contracts, we analyzed the factors that were important determinants of whether or not hospitals received contracts. We found that hospital dependence on Medi-Cal inpatient revenues was most strongly associated with winning a contract and the presence of a teaching program next most strongly related. We discuss the relative importance of hospital need for a contract and the Medi-Cal special negotiator's desire to include certain hospitals in the program, and conclude with a discussion of our study's implications for competition and regulation methods in Medicaid cost containment strategies.
尽管我们尚无法评判医疗救助计划选择性签约的广泛影响，但我们能够评估签约过程的结果以及竞争和其他因素在该过程中所起的作用。在这项针对洛杉矶县参与医疗救助计划合同投标的医院的定性和定量特征的研究中，我们分析了决定医院是否获得合同的重要因素。我们发现，医院对医疗救助计划住院收入的依赖与赢得合同的关联最为紧密，而教学项目的存在与之关联次之。我们讨论了医院对合同的需求与医疗救助计划特别谈判代表将某些医院纳入该计划的意愿的相对重要性，并最后讨论了我们的研究对医疗补助成本控制策略中的竞争和监管方法的启示。
