Hospitalization style of physicians in Manitoba: the disturbing lack of logic in medical practice.
Hospitalization style of physicians in Manitoba: the disturbing lack of logic in medical practice.
复制标题
马尼托巴省医生的住院方式：医疗实践中令人不安的缺乏逻辑。
作者：
N. Roos
小地区的住院率差异无处不在，越来越多的人认为高住院率是医生自行决定的结果。使用马尼托巴省医疗保险系统中老年患者的数据来构建一个指数，该指数根据医生收治患者的倾向将他们分为四组。然后，我确定了更倾向于接纳病人的医生是否将医院用于更自由的目的，并接纳病情较轻的病人。尽管不同执业风格的医生之间的差异是在预期的方向上，但最令人信服的发现是执业风格明显不同的医生收治的患者的特征相似。这些发现表明，医生在决定接纳患者时有很大的自由度；一个假设医生治疗模式和患者需求之间存在逻辑关系的模型并没有很好地捕捉到这种自由度。
Variations in hospital admission rates across small areas are ubiquitous, and it is increasingly assumed that high rates result from physicians' discretionary decisions. Data for elderly patients from the health insurance system of Manitoba were used to construct an index that divided physicians into four groups based on their propensity to admit patients to the hospital. I then determined whether physicians who are more prone to admit patients use hospitals for more discretionary purposes and admit patients who are less ill. Although the differences between physicians with different practice styles were in the expected direction, the most compelling finding was the similarity in characteristics of patients admitted by physicians with markedly different practice styles. Such findings suggest a very wide latitude in physicians' decisions to admit patients; this latitude is not well captured by a model that posits a logical relationship between physician treatment patterns and patient need.
基于索赔的研究中的风险调整：寻找有效的方法。
影响因子：
7.2
作者：
Roos,LL;Sharp,SM;Cohen,MM;Wajda,A
通讯作者：
Wajda,A