医者の診療所の競争と,私有保険会社が診療所訪問に支払う料金です
Laurence C Baker1, M Kate Bundorf1, Anne B Royalty2
1Stanford University School of Medicine, Stanford, California2National Bureau of Economic Research, Cambridge, Massachusetts.
JAMA
|October 22, 2014
まとめ
医者の競争の増加は,診療所訪問の民間保険料の低下に関連しています. この研究では,より高い市場集中は,より高い医療費と相関し,市場動態に対する政策的影響を示唆していることが判明しました.
科学分野:
- 健康経済学とは
- 医療市場分析 医療市場の分析
- 医師の診療所の経営管理について
背景:
- 医師の診療所の統合は,医療の質を向上させることができるが,市場勢力を高め,サービス価格の上昇につながる可能性がある.
- 医師の競争と医療価格の関係を理解することは,政策策定において極めて重要です.
研究 の 目的:
- 医者の市場における競争と,民間優先医療提供者団体 (PPO) が支払う診療費の関連性を評価する.
- 10の専門分野と1058の米国郡の価格変動を分析するために.
主な方法:
- 2010年のヒルシュマン・ハーフィンダール指数 (HHI) を使用して,医師の競争を調査した1058の米国郡の遡及的分析.
- 10種類のオフィス訪問の競争レベル (HHI) と価格との関係を評価するために,回帰分析を使用して,混同要因を制御しました.
- 2003年から2010年にかけての競争と価格の変化を分析した.
主要な成果:
- 2010年,医師市場濃度が最も高い郡 (90th percentile HHI) は,最も集中していない郡 (10th percentile HHI) に比べて,診療所訪問の価格が大幅に上昇しました.
- 価格の違いは,専門分野によって異なるが,高いHHIは,特定の訪問タイプでは5.85ドルから11.67ドルまでのコストの増加と関連している.
- 競争が少ない地域では,2003年から2010年の間に価格上昇が大きくなりました.
結論:
- 医者の間の競争の増大は,プライベートなPPOが支払う診察費の価格の低下と関連しています.
- 研究結果は,医師の診療競争を促進する政策が,医療費の上昇を緩和するのに役立つ可能性があることを示唆しています.
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