Hospital Prices Grew Substantially Faster Than Physician Prices For Hospital-Based Care In 2007-14
Hospital Prices Grew Substantially Faster Than Physician Prices For Hospital-Based Care In 2007-14
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DOI：
10.1377/hlthaff.2018.05424
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发表时间：
2019-02-01
期刊：
影响因子：
9.7
通讯作者：
Van Reenen, John
中科院分区：
文献类型：
--
作者：
Cooper, Zack;Craig, Stuart;Van Reenen, John
有证据表明，医疗服务提供者价格的上涨推动了私人投保人的医疗保健支出的增长。然而，现有的工作并没有系统地区分医院价格的增长率和医生价格的增长率。我们使用保险公司支付的实际协商价格分析了住院和医院门诊服务两种类型价格的增长。我们发现，2007-14 年期间，医院价格的增长速度明显快于医生价格的增长速度。对于住院护理，医院价格上涨了 42%，而医生价格上涨了 18%。同样，对于以医院为基础的门诊护理，医院价格上涨了 25%，而医生价格上涨了 6%。住院和医院门诊护理费用的增长大部分是由医院价格的增长推动的，而不是医生价格的增长。我们的工作表明，减少医疗保健支出的努力应主要集中于解决医院的增长问题，而不是医生价格的增长。政策制定者应考虑一系列解决医院价格增长问题的方案，包括反垄断执法、管理定价、参考定价的使用以及激励转诊医生进行更具成本效益的转诊。
Evidence suggests that growth in providers' prices drives growth in health care spending on the privately insured. However, existing work has not systematically differentiated between the growth rate of hospital prices and that of physician prices. We analyzed growth in both types of prices for inpatient and hospital-based outpatient services using actual negotiated prices paid by insurers. We found that in the period 2007-14 hospital prices grew substantially faster than physician prices. For inpatient care, hospital prices grew 42 percent, while physician prices grew 18 percent. Similarly, for hospital-based outpatient care, hospital prices grew 25 percent, while physician prices grew 6 percent. A majority of the growth in payments for inpatient and hospital-based outpatient care was driven by growth in hospital prices, not physician prices. Our work suggests that efforts to reduce health care spending should be primarily focused on addressing growth in hospital rather than physician prices. Policy makers should consider a range of options to address hospital price growth, including antitrust enforcement, administered pricing, the use of reference pricing, and incentivizing referring physicians to make more cost-efficient referrals.