Sloan F A, Morrisey M A, Valvona J
Vanderbilt University.
J Health Polit Policy Law. 1988 Spring;13(1):83-102. doi: 10.1215/03616878-13-1-83.
The number of hospitalized patients lacking an identifiable source of third-party payment has risen substantially in recent years. This study examines trends in the hospitalization of "self-pay" patients and investigates causal influences on the propensity of hospitals to accept such patients for treatment. Our analysis pays particular attention to the relationship between Medicare's prospective payment system (PPS) and hospitals' self-pay patient share. Our results show an overall increase in both the number and proportion of self-pay patients treated by hospitals between 1980 and 1985. Substantial differences existed among the types of hospitals that accepted such patients, with major teaching hospitals treating an increasingly disproportionate share. The mix of self-pay patients in terms of age, sex, and reason for hospitalization remained stable during the period under study. Our conclusion is that the regression analysis shows no evidence that PPS reduced hospitals' willingness to treat uninsured patients.
近年来，缺乏可识别第三方支付来源的住院患者数量大幅上升。本研究考察了“自费”患者的住院趋势，并调查了影响医院接受此类患者进行治疗倾向的因果因素。我们的分析特别关注医疗保险的预期支付系统（PPS）与医院自费患者比例之间的关系。我们的结果显示，1980年至1985年间，医院治疗的自费患者数量和比例总体上有所增加。接受此类患者的医院类型之间存在显著差异，主要教学医院治疗的自费患者比例越来越高。在研究期间，自费患者在年龄、性别和住院原因方面的构成保持稳定。我们的结论是，回归分析没有证据表明PPS降低了医院治疗未参保患者的意愿。
