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ESTIMATING THE INDIRECT COSTS OF TEACHING

JOURNAL OF HEALTH ECONOMICS 1992年第2期11卷 153-171页

作者： ROGOWSKI, JA NEWHOUSE, JP HARVARD UNIV CAMBRIDGEMA 02138

Medicare's Prospective Payment System pays teaching hospitals using a regression coefficient in a log-log cost function. Previous literature showed that this coefficient is sensitive to the covariates included in the function, but specified teaching intensity as the logarithm of one plus the intern and resident-to-bed ratio. Provided the true relationship is log-log, adding one biases the coefficient substantially but not predicted cost. In a re-specified equation that makes this bias negligible, the coefficient is not nearly as sensitive to the inclusion of other covariates. Because further issues remain to be explored, it is premature to use our results for policy purposes.

关键词： Medicare与Medicaid服务中心(美国) 费用分配/方法费用分配/统计学和数值数据卫生设施规模卫生服务研究医院教学/经济学医院教学/立法和法学医院教学/统计学和数值数据实习医师和住院医师职务/经济学实习医师和住院医师职务/统计学和数值数据 Medicare/经济学模型经济计量学预期支付系统/经济学支付标准制定和审核/方法支付标准制定和审核/统计学和数值数据回归分析美国

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True costs of air medical vs. ground ambulance systems

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Air Medical Journal 1993年第8期12卷 262-268页

作者： Bruhn, Jarrett D. Williams, Kenneth A. Aghababian, Richard Department of Economics Clark University United States New England Life Flight Worcester MA United States

The economic model created in this paper replaces the existing University of Massachusetts Medical Center's New England Life Flight (NELF) helicopter ambulance service with a ground ambulance system to investigate comparative costs. The model is based on a less than 30-minute response time to the patient, similar medical team staffing and equal service area. The annual budgetary cost of the replacement ground network is $3,804,000 while the helicopter ambulance costs are $1,686,500 (based on 1991 dollar). The cost per patient transported is $4,475 for the ground system and $2,811 for the helicopter system. The comparison finds that the commonly held notion that condemns helicopters as an excessively expensive technology for patient transport is incorrect. Future research to address intermediate alternatives using similar analytical technology assessment techniques is recommended. © 1993 Jems Communications.

关键词：飞机/经济学救护车/经济学费用分配/统计学和数值数据急诊室医院/经济学马萨诸塞模型经济计量学技术评估生物医学/统计学和数值数据

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A MODEL OF CAPITATION

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JOURNAL OF HEALTH ECONOMICS 1990年第4期9卷 397-409页

作者： SELDEN, TM SYRACUSE UNIV SYRACUSENY 13244 USA

This paper presents a theoretical model of capitation contracts. The consumer's ex ante choice of medical plan is derived under flexible assumptions about provider-patient decision-making. The optimal medical plan is shown to combine full insurance with a provider payment system that is a mixture of capitation and partial reimbursement of provider costs. This solution strongly parallels the ‘mixed payment’ system derived by Ellis and McGuire (1986, 1990) in the context of prospective payment, though the optimal medical plan derived below may in fact be preferred to that solution in a world with endogenous admissions.

关键词：按人收费/统计学和数值数据费用分配/统计学和数值数据决策绝对免赔额与共同保险保险健康/组织和管理管理医疗规划/经济学模型统计学预期支付系统偿还途径危险美国

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What happens when capitated behavioral health comes to town? The transition from the Fort Bragg demonstration to a capitated managed behavioral health contract

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JOURNAL OF BEHAVIORAL HEALTH SERVICES & RESEARCH 2000年第4期27卷 390-405页

作者： Heflinger, CA Northrup, DA Vanderbilt Ctr Mental Hlth Policy Nashville TN USA

Capitated managed care contracts for behavioral health services are becoming more prevalent across the country in both public and private sectors. This study followed the transition from a demonstration project for child mental health services to a capitated managed behavioral health care contract with a for-profit managed care company. The focus of the study was on the impact-at both the service system and the individual consumer level-pertaining to the start-up and maintenance of a capitated managed behavioral health program. A case study using multiple methods and multiple sources of information incorporated a program fidelity framework that examined micro to macro levels of program implementation. The findings of this study include the following: access to services decreased, the lengths of stay and average daily census in the more intensive levels of treatment declined, difficult-to-treat children were shifted to the public sector and ratings of service system performance and coordination fell.

关键词：青少年保健服务/统计学和数值数据按人收费费用分配/统计学和数值数据保健福利计划雇员卫生服务易得程度/标准卫生服务易得程度/统计学和数值数据管理医疗规划/经济学管理医疗规划/组织和管理管理医疗规划/标准管理医疗规划/统计学和数值数据精神卫生服务/经济学精神卫生服务/组织和管理精神卫生服务/标准精神卫生服务/统计学和数值数据北卡罗来纳卫生保健质量/标准卫生保健质量/统计学和数值数据回顾性研究利用情况审核/标准利用情况审核/统计学和数值数据青少年儿童人类

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