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加利福尼亚州的HMO市场透率和医院成本通胀
1Department of Social and Administrative Health Sciences, School of Public Health, University of California, Berkeley 94720.
卫生维护组织 (HMO) 在加利福尼亚州高HMO透率的市场中,将医院成本通胀率降低了9.4%. 这种竞争,受到立法变革的刺激,带来了显著的成本节约,但对通货膨胀的整体影响并不大.
科学领域:
- 卫生经济学 卫生经济学
- 医疗保健管理的管理
- 公共卫生政策 公共卫生政策
背景情况:
- 加利福尼亚州于1983年取消了对选择性合同的立法障碍,使卫生维护组织 (HMO) 能够促进价格竞争.
- 本研究研究了HMO诱导的竞争对医院成本通货膨胀的影响.
研究的目的:
- 量化HMO市场透对每次入场平均成本通胀率的影响.
- 为了估计私人非HMO医院由于HMO竞争而节省的成本.
主要方法:
- 对335万名患者 (1983年) 和341万名患者 (1988年) 的出院抽象数据进行分析,以计算HMO市场透率.
- 利用了来自美国医院协会的医院特征数据.
- 在高HMO透率市场与低HMO透率市场中,比较了每次入学成本增长率.
主要成果:
- 卫生组织的覆盖率从1983年的8.3%增加到1988年的17.0%.
- 在HMO透率较高的市场,每次入院平均年费用增长率降低了9.4% (95% CI,5.213.8).
- 据估计,1988年298家医院的成本节约达到104亿美元.
结论:
- 当立法障碍被消除时,由HMO驱动的价格竞争可以显著降低医院成本通胀.
- 虽然具有影响力,但HMO竞争对加利福尼亚州实质性医院成本通货膨胀的整体影响 (在研究期间为74.5%) 是温和的.
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