Regionalization of services within a multihospital health maintenance organization.
Regionalization of services within a multihospital health maintenance organization.
复制标题
多医院健康维护组织内的服务区域化。
作者：
H. Luft;S. Crane
在许多因素中，可以解释健康维护组织（HMO）的注册者成本较低的原因是HMO更有效地提供住院服务的可能性。虽然直接的成本比较是不合适的，但检查旧金山弗朗西斯科湾地区的凯撒计划是否将其10家医院的服务区域化是合理的。在一个回归模型中，包括医院类型、规模、规模-类型相互作用以及到最近的竞争设施的距离，对报告的43个设施/服务中的每一个的存在进行了检查。当凯撒医院的规模普遍较小时，凯撒医院的技术服务较少，并将这些服务集中在较大的医院。凯泽有更多的门诊服务。在非凯撒医院中，一些专门设施是竞争性分配的。
Among the many factors that may explain lower costs for enrollees in Health Maintenance Organizations (HMOs) is the possibility that the HMO provides inpatient services more efficiently. While direct cost comparisons are in appropriate, it is reasonable to examine whether the Kaiser program in the San Francisco Bay Area regionalizes services among its ten hospitals. The presence of each of 43 facilities/services reported is examined in a regression model that includes type of hospital, size, a size-type interaction, and the distance to the nearest competing facility. When the generally smaller size of the Kaiser hospitals was controlled for, Kaiser hospitals had fewer technologically based services and concentrated these services in larger hospitals. Kaiser had more outpatient-oriented services. Among non-Kaiser hospitals, some specialized facilities were competitively distributed.