Physician ownership of complementary medical services
Physician ownership of complementary medical services
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DOI：
10.1016/j.jpubeco.2016.09.005
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发表时间：
2016-12-01
影响因子：
9.8
通讯作者：
Yang, Chun-Yuh
中科院分区：
文献类型：
--
作者：
Chen, Brian K.;Gertler, Paul J.;Yang, Chun-Yuh
当医生拥有实验室和成像中心等补充医疗服务设施时，他们通过将患者转介到这些实体来获得经济利益。这就促使医生通过推荐更多不必要的服务来利用病人的信任。使用台湾的数据，引入了一个“分离”的政策，限制医生拥有药房，我们估计，在政策具有约束力的地方，消除这种激励导致医生处方药物减少7.1%。考虑到补充诊断服务的增加以及药物只是初级保健总支出的一部分，该政策将总支出减少了1.8%。然而，大量诊所利用法律漏洞，要么在基线时将药房纳入其做法，要么在政策后将药房纳入其做法，使其免受政策约束。结果，该政策仅将药品总支出减少了2.1%，初级保健总成本减少了0.5%。(C)© 2016 Elsevier B.V.版权所有。
When physicians own complementary medical service facilities such as laboratories and imaging centers, they gain financially by referring patients to these entities. This creates an incentive for the physician to exploit patients' trust by recommending more services than necessary. Using data from Taiwan, which introduced a "separating" policy, that restricts physician ownership of pharmacies, we estimate that where the policy was binding, eliminating this incentive caused physicians to prescribe 7.1% less in drugs. Taking into account increases in complementary diagnostic services and that drugs are only a part of overall primary care spending, the policy reduced total expenditures by 1.8%. However, a large number of clinics exploited a loophole in the law and either had at baseline or integrated pharmacies into their practices post-policy making them exempt from the policy. As a result, the policy only reduced total drug expenditures by 2.1% and total primary care cost by 0.5%. (C) 2016 Elsevier B.V. All rights reserved.