低手術料金のメディケアの医師サービス利用への影響
1Department of Medicine, University of Pennsylvania, Philadelphia.
JAMA
|May 19, 1993
まとめ
メディケア (Medicare) による医師手数料の削減
科学分野:
- 健康経済学 医療経済学
- 医者の給付改革について
- メディケア利用のメディケア利用
背景:
- メディケア料金表 (MFS) の変更は,1987年の総括予算調整法 (OBRA 87) の料金削減を反映しています.
- OBRA 87は"過高価格"の処置や診断検査のメディケア料金を削減した.
研究 の 目的:
- メディケア医師のサービス利用に対するOBRA 87料金の削減の影響を分析する.
- 新しいMFSの下での潜在的な利用の変化を予測する.
主な方法:
- OBRA 87の料金の削減により最も影響を受けた5つの専門分野を研究しました.
- 1987年と1989年のメディケア医師の請求データを分析した.
- 利用に対する料金の影響を評価するために多変数回帰を用いた.
主要な成果:
- 医師の料金の1%の減少は,サービスの量と複雑性の0.09%の減少と相関しています.
- この発見は,プールされた専門分野と回帰モデルの変数全体で一貫したままでした.
結論:
- 医療費管理局が,増額による収入の相殺を想定していることは,疑問視されている.
- 研究結果は,医師が失われた収入を完全に取り戻すという仮定が極端であることを示唆しています.
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