Are Patients Traveling Further
Are Patients Traveling Further
复制标题
患者是否需要前往更远的地方
DOI：
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复制
发表时间：
1998
期刊：
影响因子：
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通讯作者：
M. Morrisey
中科院分区：
文献类型：
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作者：
W. White;M. Morrisey
管理式医疗被假设为通过将患者引导到更远的提供者来增加患者获得医疗保健服务的旅行。这引起了准入问题。然而，如果结果是扩大供应商市场的地理范围，这可能会缓解对合并的反垄断担忧。这项研究比较了1985年和1991年从加州医院出院的病人的旅行距离，控制了付款人、诊断和当地市场条件。在此期间，私人保险患者比医疗保险患者更有可能接受管理式护理。我们预计，如果管理得当，私人患者相对于医疗保险患者的旅行距离将增加，这将导致更多的旅行。然而，对于不包括出生和新生儿出院的患者随机样本，我们没有发现相对旅行增加的证据。当我们检查根据护理的紧迫性和复杂性选择的特定诊断的旅行时，我们也没有发现系统性的增长模式。
Managed care has been hypothesized to increase patient travel for health care services by steering patients to more distant providers. This raises access concerns. However, if the result is to expand the geographic extent of provider markets, this may ease antitrust concerns about mergers. This research compares travel distances for patients discharged from California hospitals in 1985 and 1991 controlling for payor, diagnosis, and local market conditions. Privately insured patients were more likely to be in managed care than Medicare patients during this period. We expect travel distances to increase for private patients relative to Medicare patients if managed is leading to greater travel. However, for a random sample of patients excluding births and neonatal discharges, we find no evidence relative travel increased. Nor do we find a systematic pattern of increase when we examine travel for specific diagnoses selected on the basis of the urgency and complexity of care.