Birnbaum H, Bishop C, Lee A J, Jensen G
Med Care. 1981 Nov;19(11):1095-107. doi: 10.1097/00005650-198111000-00004.
Since the costs of nursing home care are a major component of the rapidly rising costs of health care, it is appropriate to base public policy discussions about cost containment on the determinants of nursing home costs. This article investigates the determinants of nursing home operating costs and reviews the results of 11 related econometric cost analyses conducted by the authors. Single-equation cost analyses are developed for nursing homes in three states and in the nation. The cost results of a multi-equation model of nursing home behavior are also reviewed. The analyses indicate that facility size and occupancy rate are minimally important in determining cost variation. Facility characteristics, particularly type of facility and ownership, are important variables. Nonprofit facilities consistently had higher costs than for-profit facilities, after controlling for patient mix and service differences, and, in one analysis, for a measure of quality.
由于疗养院护理成本是医疗保健成本迅速上升的主要组成部分，因此，基于疗养院成本的决定因素进行有关成本控制的公共政策讨论是恰当的。本文研究了疗养院运营成本的决定因素，并回顾了作者进行的11项相关计量经济学成本分析的结果。针对三个州和全国的疗养院开展了单方程成本分析。还回顾了疗养院行为多方程模型的成本结果。分析表明，设施规模和入住率在决定成本变化方面的重要性最低。设施特征，特别是设施类型和所有权，是重要变量。在控制了患者组合和服务差异后，非营利性设施的成本始终高于营利性设施，并且在一项分析中，在控制了质量指标后也是如此。
