健康维护组织（HMO）参保率及增长的决定因素。
The determinants of HMO enrollment and growth.
作者信息
Goldberg L G, Greenberg W
出版信息
Health Serv Res. 1981 Winter;16(4):421-38.
This paper analyzes why HMO enrollment and growth have varied greatly among states. Using Tobit analysis, a number of variables are related to state HMO market share in 1976 and the change in HMO market share from 1966 to 1976. Higher hospital costs and mobile populations are shown to have encouraged HMO development. There is some evidence that the extent of unionization and the presence of group practices encourages HMO enrollment and growth. Legal restrictions on HMO development imposed at the state level appear to have had little effect upon HMOs. In particular, certificate-of-need laws have not impeded HMO enrollment and growth. Consequently, our results suggest that the enrollment and growth of HMOs respond more to impersonal market and demographic conditions than to certain legal restrictions.
本文分析了健康维护组织（HMO）在各州的参保人数和增长为何差异巨大。通过托比特分析，一些变量与1976年各州HMO的市场份额以及1966年至1976年HMO市场份额的变化相关。结果表明，较高的医院成本和流动人群促使了HMO的发展。有证据显示，工会化程度和集体医疗实践的存在促进了HMO的参保人数和增长。州一级对HMO发展施加的法律限制似乎对HMO影响甚微。特别是，需求证明法并未阻碍HMO的参保人数和增长。因此，我们的研究结果表明，HMO的参保人数和增长对客观的市场和人口状况的反应，比对某些法律限制的反应更大。
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