de Lissovoy G
Department of Health Policy and Management, Johns Hopkins University, School of Hygiene and Public Health, Baltimore, Maryland 21205.
Med Care. 1988 Oct;26(10):959-70. doi: 10.1097/00005650-198810000-00004.
Since the inception of the Medicare End-Stage Renal Disease (ESRD) Program in 1972, the number of persons qualifying for this benefit has increased every year, even when controlling for growth of the US population. At the same time, the profile of the typical dialysis patient has changed dramatically over the years, with new enrollees tending to be older and sicker. This study attempts to explain case mix through an economic model of a dialysis provider who certifies eligibility of Medicare ESRD beneficiaries and manages their care. The model was tested using administrative data from the Medicare ESRD program and other sources. Results demonstrated that dialysis patient case mix is influenced by local area demand for medical care and factors such as competition or payment levels that might affect a provider's supply decisions.
自1972年医疗保险终末期肾病（ESRD）项目启动以来，即便在控制美国人口增长的情况下，符合该福利资格的人数仍逐年增加。与此同时，多年来典型透析患者的情况发生了巨大变化，新参保者往往年龄更大、病情更重。本研究试图通过一个透析服务提供者的经济模型来解释病例组合情况，该提供者负责认证医疗保险ESRD受益人的资格并管理他们的护理。该模型使用了医疗保险ESRD项目及其他来源的管理数据进行测试。结果表明，透析患者的病例组合受到当地医疗需求以及可能影响提供者供应决策的竞争或支付水平等因素的影响。
