Marcus A C
Med Care. 1981 Oct;19(10):995-1010. doi: 10.1097/00005650-198110000-00003.
Several issues relevant to Health Maintenance Organizations (HMOs) were examined in this article using data collected from the Los Angeles Health Survey. No support was found for the hypothesis that HMOs disproportionately attract people in poorer health. In fact, HMO members actually reported lower rates of acute or occasional illness and disability than fee-for-service subscribers (FFS). HMO members also reported lower total family incomes and educational status than FFS subscribers and they were less likely to report having a regular doctor. Few differences were found between the two groups in reports of using health services and practicing preventive health behavior. However, HMO members were more likely to report a recent physical examination--but only after taking into account the fact that they were less likely to have a regular doctor. It has been shown that these findings are consistent with recent evidence, and serve to amplify serveral key findings reported in other studies.
本文利用从洛杉矶健康调查收集的数据，研究了与健康维护组织（HMO）相关的几个问题。没有证据支持HMO不成比例地吸引健康状况较差人群的假设。事实上，HMO成员报告的急性或偶发性疾病及残疾发生率实际上低于按服务收费的订阅者（FFS）。HMO成员报告的家庭总收入和教育水平也低于FFS订阅者，而且他们不太可能报告有固定的医生。在使用医疗服务和采取预防健康行为的报告方面，两组之间几乎没有差异。然而，HMO成员更有可能报告最近进行了体检——但这只是在考虑到他们不太可能有固定医生这一事实之后。研究表明，这些发现与最近的证据一致，并进一步证实了其他研究报告的几个关键发现。
