Proportion Of Physicians In Large Group Practices Continued To Grow In 2009-11
Proportion Of Physicians In Large Group Practices Continued To Grow In 2009-11
复制标题
DOI：
10.1377/hlthaff.2012.1256
复制
发表时间：
2013-09-01
期刊：
影响因子：
9.7
通讯作者：
Bindman, Andrew B.
中科院分区：
文献类型：
--
作者：
Welch, W. Pete;Cuellar, Alison Evans;Bindman, Andrew B.
提高医疗质量的支付者和倡导者正在提高对更大的医疗协调和医疗服务责任的期望，医生团体可能会通过扩大规模来应对。我们使用2009-11年期间的医疗保险索赔，与医疗保险提供者注册数据库的信息合并，以衡量医生群体规模是否随着时间的推移而增加，并与医生特征相关。包括所有在任何实践环境中为医疗保险付费服务患者提供服务的美国医生。50岁以上群体中的医生比例从2009年的30.9%上升到2011年的35.6%。这种转变发生在所有专业类别、性别和所有年龄组中，尽管40岁以下的医生比60岁或60岁以上的医生更突出。医生群体化并不是一个新现象，但我们的数据表明，这些群体比以前的调查显示的要大。未来研究的问题包括是否有显着的成本节约或质量改善与实践规模的增加。
Payers and advocates for improved health care quality are raising expectations for greater care coordination and accountability for care delivery, and physician groups may be responding by becoming larger. We used Medicare claims from the period 2009-11, merged with information from the Medicare provider enrollment database, to measure whether physician group sizes have been increasing over time and in association with physician characteristics. All US physicians serving Medicare fee-for-service patients in any practice setting were included. The percentage of physicians in groups of more than fifty increased from 30.9 percent in 2009 to 35.6 percent in 2011. This shift occurred across all specialty categories, both sexes, and all age groups, although it was more prominent among physicians under age forty than those age sixty or older. The movement of physicians into groups is not a new phenomenon, but our data suggest that the groups are larger than surveys have previously indicated. Questions for future studies include whether there are significant cost savings or quality improvements associated with increased practice size.