Griffiths R I, Powe N R, Gaskin D J, Anderson G F, de Lissovoy G V, Whelton P K
Division of Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21205.
Health Serv Res. 1994 Oct;29(4):473-87.
A study was conducted to determine whether for-profit and not-for-profit freestanding renal dialysis facilities differ with respect to efficiency in the production of dialysis treatments.
DATA SOURCES/STUDY SETTING: National data on 1,224 Medicare-certified freestanding dialysis facilities were obtained from the Health Care Financing Administration's (HCFA) 1990 Independent Renal Dialysis Facility Cost Report. Data on Medicare patients receiving care at these facilities during 1990 were obtained from HCFA's End Stage Renal Disease (ESRD) Program Management and Medical Information System (PMMIS).
Ordinary least squares regression (OLS) was used to estimate the association between monthly output of dialysis treatments in 1990 and (a) facility capital and labor inputs, (b) facility ownership characteristics, and (c) case-mix characteristics.
DATA COLLECTION/EXTRACTION METHODS: Facility and patient level data were extracted from the Facility Cost Report and the PMMIS databases, respectively. Patient level data were aggregated by facility and merged with facility level data.
For-profit sole proprietorships, for-profit partnerships and for-profit corporations each produced significantly more dialysis treatments per month than not-for-profits, adjusting for quantities of resource inputs and case-mix characteristics.
For-profit facilities appear to be more efficient producers of dialysis treatments than not-for-profits. Further study should address whether other factors such as differences in severity of disease or in quality of care are responsible for these observations.
开展一项研究以确定营利性和非营利性独立肾脏透析机构在透析治疗生产效率方面是否存在差异。
数据来源/研究背景：关于1224家获得医疗保险认证的独立透析机构的全国性数据，取自医疗保健财务管理局（HCFA）1990年的独立肾脏透析机构成本报告。1990年在这些机构接受治疗的医疗保险患者的数据，取自HCFA的终末期肾病（ESRD）项目管理与医疗信息系统（PMMIS）。
采用普通最小二乘法回归（OLS）来估计1990年透析治疗月产量与以下因素之间的关联：（a）机构资本和劳动力投入；（b）机构所有权特征；（c）病例组合特征。
数据收集/提取方法：机构层面和患者层面的数据分别从机构成本报告和PMMIS数据库中提取。患者层面的数据按机构进行汇总，并与机构层面的数据合并。
在对资源投入量和病例组合特征进行调整后，营利性独资企业、营利性合伙企业和营利性公司每月生产的透析治疗量均显著高于非营利性机构。
营利性机构似乎比非营利性机构在透析治疗生产方面更具效率。进一步的研究应探讨诸如疾病严重程度差异或护理质量差异等其他因素是否导致了这些观察结果。
