Gawande A A, Blendon R, Brodie M, Benson J M, Levitt L, Hugick L
Harvard School of Public Health, Boston, MA, USA.
Health Aff (Millwood). 1998 Sep-Oct;17(5):184-94. doi: 10.1377/hlthaff.17.5.184.
Data from a 1997 nationwide telephone survey are used to assess the relationship between choice and public opinion about managed care. We found that only a minority of the working-age population effectively control what health plan they get. Persons without choice were markedly more dissatisfied with their health plan, especially when enrolled in managed care. In multivariate analysis, how respondents rated their health plan depended as much on whether they lacked choice as on whether they were enrolled in managed care. Persons without choice also had more negative opinions about managed care in general. The results suggest that the managed care "backlash" may persist so long as consumers have little control over health insurance decisions.
1997年全国电话调查的数据被用于评估选择与公众对管理式医疗的看法之间的关系。我们发现，只有少数工作年龄人口能有效控制自己获得的健康保险计划。没有选择权的人对自己的健康保险计划明显更不满意，尤其是在加入管理式医疗时。在多变量分析中，受访者对其健康保险计划的评价，在很大程度上既取决于他们是否缺乏选择权，也取决于他们是否加入了管理式医疗。总体而言，没有选择权的人对管理式医疗也有更多负面看法。结果表明，只要消费者对医疗保险决策几乎没有控制权，管理式医疗的“强烈抵制”可能就会持续存在。
