Perlman B B, Schwartz A H, Thornton J C, Weber R, Schmidt K, Smith H, Nagelberg S, Paris M
N Engl J Med. 1978 Aug 3;299(5):230-4. doi: 10.1056/NEJM197808032990505.
Data were obtained from the tax records and the Professional Registry maintained by the New York City Department of Health as well as from the Biographical Directory of the American Psychiatric Association to determine which psychiatrists were providing care under the Medicaid Program and how they compare with the pool of psychiatric practitioners in New York City. The data reveal that psychiatrists educated in foreign medical schools provide disproportionately more care to Medicaid recipients than would be anticipated from their numbers, and are a majority of those who received more than +30,000 in payments in 1976. Furthermore, these psychiatrists account for 80 per cent of those delivering care at the two largest "shared health facilities," commonly referred to as "Medicaid mills." These findings indicate that although the Title XIX Program has facilitated the access of the poor to the private psychiatric sector, in New York City their access is biased toward treatment by foreign-educated psychiatrists.
数据来自税收记录、纽约市卫生部维护的专业登记册以及美国精神病学协会的传记名录，以确定哪些精神科医生在医疗补助计划下提供护理，以及他们与纽约市精神科从业者群体相比情况如何。数据显示，毕业于外国医学院的精神科医生为医疗补助接受者提供的护理比根据其数量预期的要多得多，并且在1976年获得超过30,000美元报酬的人中占多数。此外，这些精神科医生在两个最大的“共享健康设施”（通常称为“医疗补助工厂”）中提供护理的人员中占80%。这些发现表明，尽管第十九条计划促进了穷人进入私立精神科领域，但在纽约市，他们获得治疗的机会偏向于由毕业于外国的精神科医生提供。
