医生实践竞争和私人保险公司为办公室访问支付的价格
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
概括
增加医生竞争与较低的私人医疗保险价格有关. 这项研究发现,更高的市场度与更高的医疗保健成本相关,这表明对市场动态的政策影响.
科学领域:
- 卫生经济学 卫生经济学
- 医疗保健市场分析
- 医生实践管理的管理
背景情况:
- 医生实践的整合可以提高护理质量,但也可能增加市场力量,可能导致服务价格上.
- 了解医生竞争与医疗保健定价之间的关系对于政策制定至关重要.
研究的目的:
- 评估医生市场竞争与私人优先提供者组织 (PPO) 支付的办公室访问价格之间的关联.
- 分析10个专业和1058个美国县的价格变化.
主要方法:
- 2010年使用希尔施曼-赫芬达尔指数 (HHI) 对1058个美国县检查医生竞争的回顾性分析.
- 通过回归分析,评估了10种类型的办公室访问的竞争水平 (HHI) 和价格之间的关系,并控制了混因素.
- 分析了2003年至2010年间的竞争和价格变化.
主要成果:
- 2010年,医生市场度最高的县 (第90个百分点HHI) 与度最低的县 (第10个百分点HHI) 相比,办公室访问的价格显著更高.
- 价格差异因专业而异,较高的HHI与特定访问类型的成本增加相关,从5.85美元到11.67美元不等.
- 竞争较弱的地区在2003年至2010年间经历了更大的价格上.
结论:
- 医生之间更大的竞争与私人公共医疗组织支付的办公室访问价格较低有关.
- 调查结果表明,旨在促进医生实践竞争的政策可能有助于缓解不断上升的医疗保健成本.
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