Glied S A, Gnanasekaran S
Division of Health Policy and Management, Columbia University School of Public Health, New York, NY 10032, USA.
Health Serv Res. 1996 Dec;31(5):593-607.
To investigate the relationship between hospital financing patterns and hospital resources for the care of babies born at low birthweight in New York City.
Data on neonatal care beds in New York City hospitals for 1991, obtained from the Greater New York Hospital Association, which were matched to 1991 hospital-specific birthweight and payment distributions from the New York State Department of Health.
Statistical analyses were used to assess the relationship between insurance and beds across all hospitals and across hospitals classified by ownership and teaching status.
After adjusting for low birthweight and other measures of patient need and for hospital affiliation, the study finds that hospitals with more privately insured patients, especially those with more privately insured low-birthweight newborns, have statistically significantly more neonatal intensive care beds than do those with fewer such patients. This result persists within hospital affiliation categories.
These results suggest that differences in the care received by privately insured, Medicaid insured, and uninsured low-birthweight babies may stem from differences in the resources available to the hospitals that treat these patients.
研究纽约市医院的融资模式与照顾低体重出生婴儿的医院资源之间的关系。
1991年纽约市医院新生儿护理床位的数据,取自大纽约医院协会,并与纽约州卫生部提供的1991年各医院特定的出生体重和支付分布数据相匹配。
采用统计分析方法评估所有医院以及按所有权和教学状况分类的医院中保险与床位之间的关系。
在对低体重以及患者需求的其他衡量指标和医院附属关系进行调整后,研究发现,拥有更多私人保险患者的医院,尤其是那些拥有更多私人保险低体重新生儿的医院,其新生儿重症监护床位在统计上显著多于此类患者较少的医院。这一结果在医院附属关系类别中持续存在。
这些结果表明,私人保险、医疗补助保险和未参保的低体重婴儿所接受护理的差异,可能源于治疗这些患者的医院可获得资源的差异。