医生与医院的垂直整合是否会影响医院产出？
Does Physician-Hospital Vertical Integration Affect Hospital Output?
作者信息
Upadhyay Soumya, Bhandari Neeraj
机构信息
Department of Healthcare Administration and Policy, School of Public Health, University of Nevada at Las Vegas, Las Vegas, NV, USA.
出版信息
Health Serv Insights. 2024 Dec 14;17:11786329241304619. doi: 10.1177/11786329241304619. eCollection 2024.
BACKGROUND
Physician-hospital vertical integration is gaining steam but it is unclear how they affect hospital output.
OBJECTIVE
To examine the direct impact of vertical integration on hospital output.
DESIGN
A pooled design with 6-year data using linear regressions was used. Then, panel data design with hospital fixed effects was used.
METHODS
We linked American Hospital Association data (2016-2021) with AHRQ Comparative Health System Performance Initiative's Compendium (2018, 2020, 2021; 34 987 hospital-year observations) to develop new measures of vertical integration and assess its relationship with several measures of hospital output including annualized total admissions, total number of inpatients days, and total number of emergency department (ED) and outpatient visits.
RESULTS
We find that a hospital's entry into a vertical integration has little or no impact on a broad set of metrics capturing hospital output.
CONCLUSION
Our findings suggest that vertical integrations as currently structured may not yield meaningful gains in output or productivity and hospitals faced with declining productivity need to carefully consider the expected gains from vertical integration strategies.
背景
医师-医院垂直整合正在兴起，但尚不清楚它们如何影响医院产出。
目的
研究垂直整合对医院产出的直接影响。
设计
采用线性回归的六年数据混合设计。然后，采用具有医院固定效应的面板数据设计。
方法
我们将美国医院协会数据（2016 - 2021年）与美国医疗保健研究与质量局（AHRQ）比较卫生系统绩效倡议纲要（2018年、2020年、2021年；34987个医院年度观察值）相链接，以制定垂直整合的新指标，并评估其与医院产出的若干指标的关系，这些指标包括年化总入院人数、住院总天数以及急诊科和门诊就诊总数。
结果
我们发现，医院进入垂直整合对一系列广泛的衡量医院产出的指标几乎没有影响。
结论
我们的研究结果表明，目前结构的垂直整合可能不会在产出或生产率方面带来有意义的提升，面临生产率下降的医院需要仔细考虑垂直整合战略的预期收益。
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