Changes in Medicaid Physician Fees and Patterns of Ambulatory Care

Changes in Medicaid Physician Fees and Patterns of Ambulatory Care
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DOI:
10.5034/inquiryjrnl_46.03.291
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发表时间:
2009-09-01
影响因子:
1.7
通讯作者:
Decker, Sandra L.
Decker, Sandra L.
中科院分区:
医学4区
文献类型:
--
作者:
Decker, Sandra L.

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在控制了国家固定效应和其他因素后,本文估计了与私人保险患者相比,医疗补助医生支付水平的慷慨程度对医疗补助患者接受门诊护理的数量和地点的影响。结果表明,与私人保险患者相比,医疗补助医生费用的削减导致医疗补助患者的就诊次数在统计上显著减少。费用的削减还导致了从医生办公室转向医院急诊科,特别是门诊部的统计上的重大转变。治疗地点转移最明显的主要诊断包括高血压、哮喘、尿路感染和糖尿病。
Controlling for state fixed effects and other factors, this paper estimates the effect of the generosity of Medicaid physician payment levels on the volume and site of ambulatory care received by Medicaid patients compared to privately insured patients. Results indicate that cuts in Medicaid physician fees lead to statistically significant reductions in the number of visits for Medicaid patients compared to privately insured patients. Cuts in fees also lead to a statistically significant shift away from physician offices and toward hospital emergency departments and especially outpatient departments. Primary diagnoses for which site of care shifts are most pronounced include hypertension, asthma, urinary tract infections, and diabetes.