Mann J, Melnick G, Bamezai A, Zwanziger J
RAND, Santa Monica, CA, USA.
Health Aff (Millwood). 1995 Spring;14(1):263-70. doi: 10.1377/hlthaff.14.1.263.
This Data Watch examines the impact of hospital competition, the Medicare prospective payment system (PPS), and Medi-Cal selective contracting on the provision of uncompensated care by private hospitals in California during 1980-1989. It finds that hospitals subject to more intense competition and greater fiscal pressure from Medicare and Medi-Cal reduced their provision of uncompensated care relative to hospitals facing less pressure from these sources. We estimate that had hospitals not been subjected to increasing price competition from growth of managed care plans and financial tightening in public programs, they would have provided 36 percent more uncompensated care than was actually provided in 1989.
本数据观察报告研究了1980 - 1989年期间医院竞争、医疗保险预期支付系统（PPS）以及加州医疗补助选择性合同对加州私立医院提供无偿护理的影响。研究发现，相对于来自这些方面压力较小的医院，面临更激烈竞争以及来自医疗保险和加州医疗补助更大财政压力的医院减少了无偿护理的提供。我们估计，如果医院没有受到管理式医疗计划增长带来的价格竞争加剧以及公共项目财政紧缩的影响，它们在1989年提供的无偿护理会比实际提供的多36%。
