Gold M, Nelson L, Brown R, Ciemnecki A, Aizer A, Docteur E
Health Aff (Millwood). 1997 Sep-Oct;16(5):149-62. doi: 10.1377/hlthaff.16.5.149.
This study presents new data from a 1996 national survey of Medicare risk enrollees and disenrollees designed to profile access to care in Medicare health maintenance organizations (HMOs). The findings show that expanded benefits and low (or no) premiums are major features attracting disabled Medicare beneficiaries into Medicare HMOs. We found that most disabled persons enrolled in Medicare HMOs do not experience access problems. However, they are more likely than nondisabled Medicare HMO enrollees to experience such problems. We conclude by highlighting the importance of having information to monitor access to care for vulnerable subgroups such as disabled Medicare beneficiaries and to develop incentives to serve them well in Medicare HMOs.
本研究展示了1996年一项针对医疗保险风险参保者和退保者的全国性调查的新数据，该调查旨在描绘医疗保险健康维护组织（HMO）中获得医疗服务的情况。研究结果表明，扩大福利范围以及低（或无）保费是吸引残疾医疗保险受益人加入医疗保险HMO的主要特征。我们发现，大多数加入医疗保险HMO的残疾人并未遇到就医困难。然而，与非残疾的医疗保险HMO参保者相比，他们更有可能遇到此类问题。我们在结论中强调了获取信息以监测弱势亚群体（如残疾医疗保险受益人）获得医疗服务情况的重要性，以及制定激励措施以便在医疗保险HMO中为他们提供良好服务的重要性。
