Rizzo J A, Goddeeris J H
Yale University, USA.
J Health Polit Policy Law. 1998 Jun;23(3):483-515. doi: 10.1215/03616878-23-3-483.
Legal suits contesting the denial or termination of hospital staff privileges are the most common antitrust cases involving medical markets. There is, however, very little evidence about the economic implications for the physicians of having staff privileges. Using a nationally representative sample of self-employed physicians from 1992, this article presents estimates of the effects of hospital admitting privileges on physician earnings. The results indicate that for nonprimary care specialists with few admitting privileges, gaining an additional privilege increase earnings. This effect diminishes as the number of admitting privileges increases, however, and there are no economic gains beyond having three to four admitting privileges. Among primary care physicians, we detect no statistically significant effect of hospital admitting privileges on earnings. With the growing emphasis on managed care, physicians are being scrutinized both in terms of the quality of care they deliver and their impact on the economic performance of hospitals and managed care organizations. This suggests that the frequency of lawsuits involving the denial or rescission of medical staff privileges may assume even greater importance.
质疑医院员工特权被拒绝或终止的法律诉讼是涉及医疗市场的最常见反垄断案件。然而，关于拥有员工特权对医生的经济影响，几乎没有证据。本文利用1992年具有全国代表性的个体执业医生样本，给出了医院收治特权对医生收入影响的估计。结果表明，对于收治特权较少的非初级保健专科医生来说，额外获得一项特权会增加收入。然而，随着收治特权数量的增加，这种影响会减弱，拥有三到四项收治特权之后就没有经济收益了。在初级保健医生中，我们没有发现医院收治特权对收入有统计学上的显著影响。随着对管理式医疗的日益重视，医生在其所提供医疗服务的质量以及他们对医院和管理式医疗组织经济绩效的影响方面都受到了审视。这表明，涉及拒绝或撤销医务人员特权的诉讼频率可能会变得更加重要。
