Baker L C, Cantor J C
Department of Economics, Princeton University.
Health Aff (Millwood). 1993;12 Suppl:258-70. doi: 10.1377/hlthaff.12.suppl_1.258.
Data from a survey of young physicians have been analyzed to study the relationship between practicing medicine under managed care and the levels of perceived professional autonomy, practice satisfaction, and career satisfaction. Although practicing under managed care is associated with lower levels of perceived autonomy in patient selection and time allocation, it is associated with higher levels of perceived autonomy in use of hospital care, tests, and procedures. Specialists associated with managed care perceive more autonomy than generalists. Analyses of physicians' satisfaction with their practices and careers show that practicing under managed care is not uniformly associated with lower levels of satisfaction. Overall, managed care does not seem to have had the deleterious impact on medical practice that was forecast for it.
一项针对年轻医生的调查数据已被分析,以研究在管理式医疗下行医与感知到的职业自主权水平、执业满意度和职业满意度之间的关系。尽管在管理式医疗下行医与在患者选择和时间分配方面感知到的自主权水平较低相关,但它与在使用医院护理、检查和程序方面感知到的自主权水平较高相关。与管理式医疗相关的专科医生比全科医生感知到更多的自主权。对医生对其执业和职业的满意度分析表明,在管理式医疗下行医并不总是与较低的满意度相关。总体而言,管理式医疗似乎并未对医疗实践产生当初所预测的有害影响。