Dowd B E
Health Serv Res. 1986 Jun;21(2 Pt 1):177-88.
From 1977 to 1982, the admission rate in Minneapolis-St. Paul (Twin Cities) has been falling faster than the national average, and faster than the rate in selected comparison metropolitan areas. A natural question regards the impact of Twin Cities HMOs on decreased admission rates. This analysis shows that one's estimate of the HMO effect on total admission rates depends crucially on the estimated "spillover" effect, that is, the effect of HMOs on the non-HMO sector. Using secondary age-adjusted data, the analysis provides estimates of upper and lower bounds on the HMOs' effect on admission rates.
1977年至1982年期间，明尼阿波利斯 - 圣保罗（双子城）的住院率下降速度比全国平均水平更快，且比选定的对比大都市地区的下降速度更快。一个自然而然的问题是双子城健康维护组织（HMO）对住院率下降的影响。该分析表明，一个人对HMO对总住院率的影响的估计关键取决于估计的“溢出”效应，即HMO对非HMO部门的影响。利用二次年龄调整数据，该分析提供了HMO对住院率影响的上限和下限估计。
