Cooper P F, Nichols L M, Taylor A K
Agency for Health Care Policy and Research, Rockville, MD 20852, USA.
Inquiry. 1996 Fall;33(3):237-46.
Generous health insurance coverage is widely believed to have contributed to both high and rising health care costs. This paper tests the hypothesis that better insured patients will demand higher "quality" by choosing more often to visit specialists rather than generalist physicians. We model the conditional decision to seek care from a specialist physician as a function of health insurance status, physician characteristics, and other socioeconomic factors. Analysis of data from the 1987 National Medical Expenditure Survey and the American Medical Association suggests that the presence of insurance coverage does not affect choice of physician. The results do show that people enrolled in health maintenance organizations (HMOs) see specialists less often than other patients.
人们普遍认为，慷慨的医疗保险覆盖范围是造成医疗成本居高不下且不断上涨的原因之一。本文检验了这样一种假设，即保险覆盖范围更广的患者会更频繁地选择看专科医生而非全科医生，从而要求更高的“医疗质量”。我们将寻求专科医生治疗的条件性决策建模为医疗保险状况、医生特征及其他社会经济因素的函数。对1987年国家医疗支出调查和美国医学协会的数据进行分析后发现，保险覆盖范围的存在并不影响医生的选择。结果确实表明，参加健康维护组织（HMO）的人看专科医生的频率低于其他患者。
