SOME INTERIM RESULTS FROM A CONTROLLED TRIAL OF COST-SHARING IN HEALTH-INSURANCE
SOME INTERIM RESULTS FROM A CONTROLLED TRIAL OF COST-SHARING IN HEALTH-INSURANCE
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DOI：
10.1056/nejm198112173052504
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发表时间：
1981-01-01
影响因子：
158.5
通讯作者：
BROOK, RH
中科院分区：
文献类型：
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作者：
NEWHOUSE, JP;MANNING, WG;BROOK, RH
共有7706人参加了替代健康保险政策的对照试验。中期结果表明，完全享有医疗服务的人比拥有与收入有关的巨灾保险的同类人多支出约50%。全面覆盖会导致更多的人使用服务，每个用户也会获得更多的服务。门诊服务和住院人数都增加了。然而，一旦病人被送入医院，每次住院的费用在不同的实验保险计划之间并没有显著差异。此外，儿童住院率不会因计划而异。实验计划中与收入相关的成本分担对不同收入群体的支出影响相似，但成年人的总支出差异大于儿童。目前还没有足够的数据表明，获得免费医疗的人使用率较高是否反映了过度使用，或者获得与收入有关的巨灾保险的人使用率较低是否反映了使用率不足。两者很可能都是真的。（中华医学杂志。1981;35:1501 - 07）
A total of 7706 persons are participating in a controlled trial of alternative health-insurance policies. Interim results indicate that persons fully covered for medical services spend about 50 per cent more than do similar persons with income-related catastrophe insurance. Full coverage leads to more people using services and to more services per user. Both ambulatory services and hospital admissions increase. Once patients are admitted to the hospital, however, expenditures per admission do not differ significantly among the experimental insurance plans. In addition, hospital admissions for children do not vary by plan.The income-related cost sharing in the experimental plans affects expenditure by different income groups similarly, but adults' total expenditure varies more than children's. Sufficient data are not available on whether higher use by persons with free care reflects overuse, or whether lower use by those with income-related catastrophe coverage reflects underuse. Both may well be true. (N Engl J Med. 1981; 305:1501–7.)