Pett L J
Med Care. 1979 Apr;17(4):420-9. doi: 10.1097/00005650-197904000-00010.
The HMO Act of 1973 gives impetus on a nationwide scale to the development of health care delivery systems capable of providing or arranging for comprehensive health services for our nation's consumers. However, while the organizational mode of the group-practice model HMO is well defined and tested, there has not been a similar "track record" established for the individual practice HMO. In this study, the author compares the utilization of hospital beds in two operating programs: an individual practice and a group-practice HMO, serving employees of the Government of Guam, U.S.A. Substantial differences in utilization between the two systems are observed over a 12-month period. With the focus on developing the IPA to meet the objectives for which it is intended, it is suggested that organizational structure, provider incentives, and how utilization controls were employed account for the discrepancy.
1973年的《健康维护组织法案》在全国范围内推动了能够为美国消费者提供或安排全面健康服务的医疗保健提供系统的发展。然而，虽然团体执业模式的健康维护组织的组织模式已得到明确界定和测试，但个人执业健康维护组织尚未建立类似的“业绩记录”。在本研究中，作者比较了两个运营项目中病床的使用情况：一个是个人执业健康维护组织，另一个是团体执业健康维护组织，它们为美国关岛政府的雇员提供服务。在12个月的时间里，观察到这两个系统在使用方面存在显著差异。鉴于重点是发展独立执业协会以实现其预期目标，建议组织结构、提供者激励措施以及使用控制的方式可以解释这种差异。
