Julnes T E, Baker T A
School of Urban and Public Affairs, Portland State University, OR 97207-0751.
J Fam Pract. 1993 Jul;37(1):35-43.
This study applies the concept of economic efficiency to primary health care physicians. Comparisons of charges made by family physicians and general internists would provide evidence of "optimal" health care delivery of primary care services.
A list of all active licensed primary care physicians was obtained from the office of the Oregon State Board of Medical Examiners. Two thousand eight hundred forty-three questionnaires were sent to Oregon primary care physicians. Of the 1365 responses, 484 were family physicians and 341 were general internists.
The study found that family physicians had significantly lower mean office visit fees than general internists, while both groups had essentially similar patient mixes. This difference in fees could not be explained by patient case mix.
The findings of this study and the body of literature available support the concept that family practice physicians provide economically efficient primary health care. If two similarly trained physicians provide a comparable level of medical care, with the same or similar outcome (or output), the physician who provides the care for the lowest cost should be used.
本研究将经济效率概念应用于初级保健医生。比较家庭医生和普通内科医生的收费情况,可为初级保健服务的“最佳”医疗服务提供证据。
从俄勒冈州医学考试委员会办公室获取所有在职执业初级保健医生名单。向俄勒冈州初级保健医生发送了2843份问卷。在1365份回复中,484名是家庭医生,341名是普通内科医生。
研究发现,家庭医生的平均门诊费用显著低于普通内科医生,而两组的患者构成基本相似。费用差异无法用患者病例组合来解释。
本研究结果及现有文献支持这样一种观点,即家庭医生提供经济高效的初级卫生保健。如果两名训练程度相似的医生提供可比水平的医疗服务,且结果相同或相似(或产出相同),则应选择成本最低的医生提供医疗服务。