Cleverley W O, Nutt P C
Health Serv Res. 1984 Dec;19(5):615-37.
Investigation of the process of hospital bond rating related the ratings assigned by Moody's and Standard and Poors to indicators of hospital financial condition (such as debt per bed and peak debt coverage), institutional factors (including size, occupancy, and local market competition), indenture provisions (such as reserves), and contextual factors. The criteria used by Moody's and Standard and Poors to rate hospital bonds were revealed to be similar, but not identical. Criteria used in the bond rating process have several important implications: the rating approach provides strong financial incentives for increases in hospital size and complexity, for example, and hospitals that rely on extensive amounts of public financing appear to be penalized in the rating process.
对医院债券评级过程的调查涉及穆迪和标准普尔赋予医院财务状况指标（如每张床位的债务和峰值债务覆盖率）、机构因素（包括规模、入住率和当地市场竞争）、契约条款（如储备金）以及背景因素的评级。结果显示，穆迪和标准普尔用于评定医院债券的标准相似，但并不完全相同。债券评级过程中使用的标准有几个重要影响：例如，评级方法为医院规模和复杂性的增加提供了强大的财务激励，而且在评级过程中，依赖大量公共融资的医院似乎受到了惩罚。
