公共和私人选择在实践中:军事卫生系统
Michael D Frakes1, Jonathan Gruber2, Timothy Justicz3
1Duke University and National Bureau of Economic Research, 210 Science Drive, PO Box 90362, Durham, NC 27708.
概括
军事卫生系统 (MHS) 在基地外提供的分娩护理显示成本略高,但患者结果更好. 这表明,私营部门参与军事医疗保健可能带来效率提升.
科学领域:
- 卫生经济学 卫生经济学
- 公共卫生政策 公共卫生政策
- 军事医疗保健系统 军事医疗保健系统
背景情况:
- 关于医疗改革的辩论往往集中在公共与私人服务提供之间.
- 军事卫生系统 (MHS) 和退伍军人事务是医疗改革讨论的关键领域.
- 了解MHS内的护理效率和结果至关重要.
研究的目的:
- 调查收到产科护理对军事基地和军事基地之外的影响.
- 分析资源密集度和与MHS内的不同护理地点相关的患者结果.
- 评估私营部门参与军事产科的潜在效率提升.
主要方法:
- 利用了来自MHS分娩索赔的新数据.
- 雇佣的病人作为可信的外源变异移动.
- 在不同军事设施的基础医院的可用性中利用异质性.
主要成果:
- 基地外的产科护理与稍微更大的资源密集度有关.
- 与基地外护理相比,基地外护理表现出明显更好的患者结果.
- 调查结果表明,与私营部门的护理服务相关的边际效率增长很小.
结论:
- 在MHS内产科护理的私有化可能会带来效率的好处.
- 在医疗改革讨论中,平衡资源强度和患者结果是关键.
- 证据支持进一步检查军事医疗保健中的私人护理模式.
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