Department of Economics, Wesleyan University, Middletown, Connecticut, USA.
Health Econ. 2022 Nov;31(11):2333-2368. doi: 10.1002/hec.4584. Epub 2022 Aug 10.
This study evaluates whether hospital costs are lower when hospitals integrate with physician practices. It addresses a common element in policy attempts to contain healthcare costs, which is to encourage greater coordination in healthcare delivery. Despite a clear trend toward greater hospital-physician integration, there is little direct evidence about whether integration lowers hospital costs. The results in this paper show that hospital costs increase by one to three percent after hospital-physician integration. We also do not find consistent evidence that hospital-physician integration is associated with higher quality but potentially more costly hospital care. The modest increase in hospital costs appears to derive from an increase in outpatient visits, rather than from higher costs of inpatient care. These findings do not support the hypothesis that increased coordination between hospitals and physicians has led to lower hospital costs.
这项研究评估了医院与医生实践整合时医院成本是否更低。它解决了政策试图控制医疗保健成本的一个共同要素，即鼓励在医疗保健提供中更大程度的协调。尽管医院-医生整合的趋势明显，但关于整合是否降低医院成本的直接证据很少。本文的结果表明，医院-医生整合后，医院成本增加了 1%至 3%。我们也没有发现一致的证据表明医院-医生整合与更高质量但潜在成本更高的医院护理有关。医院成本的适度增加似乎来自于门诊就诊次数的增加，而不是住院护理成本的增加。这些发现不支持增加医院和医生之间的协调导致医院成本降低的假设。
