DECADE OF PSYCHIATRY--IMPACT OF COMPETITION

这里提出了一项新的研究，以利用最近的一项调查 20世纪80年代中期精神病学家的执业模式。它是 假设在两个需求上不断增强的竞争力- 而精神健康服务市场的供给方 加大了精神科医生执业模式的压力 20世纪70年代末至80年代中期的收入。具体目标 是比较精神科医生随着时间推移的经济地位 其他专业的内科医生，并记录 收入、费用、工作量和工作量方面的竞争。这个 这项拟议研究的成果将是一份关于 近十年的精神病学实践，重点放在 竞争的影响。 该建议利用了几个广泛的数据库，这些数据库 已经组装完毕：具有全国代表性的样品 在1977、1978、1979和1984-85年间接受调查的精神病学家 国家民意研究中心。这些数据库已经被 通过添加州、县、 和医院层面。分析文件是唯一的资源，具有 用来研究精神科医生执业模式的趋势。 描述性和多变量分析将(A)记录 行业内的执业模式和收入；(B)比较 精神科医生和其他医生在过去一年的经济地位 过去十年；(C)描述精神健康保险的影响 条例；(D)说明变化的方向和程度 精神科医生参加医疗保险和医疗补助的情况；(E)审查 医院隶属关系的趋势；(F)确定 年，精神病学家加入了替代健康计划(例如，HMO、PPO) 20世纪80年代中期；和(G)评估精神病学家是否面临更多 比其他医生更具竞争力的环境。

A new study is proposed here to take advantage of a recent survey of psychiatrists' practice patterns in the mid-1980s. It is hypothesized that mounting competitive forces on both the demand- and supply-sides of the mental health services market have intensified the pressures on psychiatrists' practice patterns and earnings from the late-1970s to the mid-1980s. The specific aims are to compare psychiatrists' economic position over time to that of physicians in other specialties and to document the effect of competition on incomes, fees, work effort, and workloads. The product of this proposed study would be a comprehensive profile of psychiatric practice over nearly a decade, with an emphasis on the effect of competition. This proposal takes advantage of several extensive data bases that have already been assembled: nationally representative samples of psychiatrists surveyed in 1977, 1978, 1979 and 1984-85, by the National Opinion Research Center. These data bases have been enhanced with the addition of secondary data at the state, county, and hospital level. The analytic file is a unique resource with which to study trends in psychiatrists' practice patterns. Descriptive and multivariate analyses will (a) document changes in practice patterns and earnings within the profession; (b) compare the economic status of psychiatrists and other physicians over the past decade; (c) describe the effects of mental health insurance regulation; (d) show the direction and magnitude of changes in psychiatrists' participation in Medicare and Medicaid; (e) examine trends in hospital affiliation; (f) determine the likelihood that a psychiatrist joined an alternate health plan (e.g., HMO, PPO) in the mid-1980s; and (g) assess whether psychiatrists face a more competitive environment than other physicians.