一个健康计划有什么不同? 在医疗补助中随机计划分配的证据
Michael Geruso1, Timothy J Layton2, Jacob Wallace3
1UT-Austin and NBER.
American economic journal. Applied economics
|August 25, 2023
概括
支出较低的管理护理计划减少了医疗服务,包括高价值护理,对患者的健康和满意度产生了负面影响. 消费者选择推动了更高的支出,使政府合同和成本控制复杂化.
科学领域:
- 卫生经济学 卫生经济学
- 管理护理政策 管理护理政策
- 医疗保健利用率 医疗保健利用率
背景情况:
- 管理护理计划旨在通过利用管理来控制成本.
- 跨计划的支出存在差异,即使具有相同的成本共享结构.
研究的目的:
- 调查具体计划支出差异对医疗保健利用,受益者结果和消费者选择的影响.
- 分析管理护理计划支出与市场份额之间的关系.
主要方法:
- 使用准实验性设计,利用受益人随机分配到管理护理计划中.
- 分析了特定计划的支出,服务利用率,受益人的满意度和健康结果.
主要成果:
- 纳入低支出计划将整体支出减少至少25%,主要是通过减少服务量.
- 较低的支出计划减少了低成本和高价值护理的提供,导致受益人的满意度和健康状况更差.
- 计划支出增加10%与市场份额增加40%相关.
结论:
- 具体计划支出变化显著影响医疗保健和患者福祉,而不仅仅是"浪费"支出.
- 消费者偏好与更高的支出计划保持一致,这给政府的成本控制策略带来了挑战.
- 这些发现对政府签订合同和管理医疗保健计划支出产生了重大影响.
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