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首页> 外文期刊>Journal of Health Services Research & Policy >The impact of managed care and practice size on primary care physicians' perceived ability to refer
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The impact of managed care and practice size on primary care physicians' perceived ability to refer

机译：管理式护理和执业规模对初级保健医生感知的推荐能力的影响

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摘要

Objectives: To identify the determinants of primary care physicians' perceived ability to refer patients, to compare perceived ability to refer between solo/two-physician practices and group practices, and to determine the impact of managed care on perceived ability to refer. nnMethods: Multivariate analysis using a dataset derived from the Community Tracking Study Physician Survey, 1996-1997. The variables used to explain physicians' perceived ability to refer included physician and practice characteristics as well as aspects of the financial arrangements of managed care. The sample was stratified by practice size. A likelihood ratio test was performed to determine whether there were differences in practice characteristics and managed care financial arrangements that could explain variations in perceived ability to refer between physicians in solo/two-physician and group practices. nnResults: Perceived ability to refer did not vary much between physicians in solo/two-physician practices and those in group practices. However, the determinants of perceived ability to refer did vary by practice size. The effects of physicians' characteristics were more pronounced among physicians in group practice, whereas the effects of financial arrangements were significant for physicians in solo/two-physician practices. The most significant determinant of perceived ability to refer was primary care physicians' satisfaction in their communication with specialists. nnConclusion: Group practices are more immune than solo/two-physician practices to external financial arrangements from managed care contracts, possibly through their ability to take advantage of economies of scale and to diversify their sources of funds.
机译：目的：确定初级保健医师感知病人的参考能力的决定因素，比较独/二医师实践和团体实践之间的感知参考能力，并确定管理式护理对感知参照能力的影响。 nn方法：使用从“社区跟踪研究医师调查”获得的数据集进行多变量分析，1996-1997年。用于解释医师感知的参考能力的变量包括医师和执业特征以及管理式医疗的财务安排方面。通过实践规模对样本进行分层。进行了似然比测试，以确定在实践特征和管理型医疗财务安排方面是否存在差异，这些差异可以解释在单人/两位医师和团体实践中医生之间的推荐能力差异。 nn结果：在独奏/两位医师实践中和在集体实践中，被指称的参考能力差异不大。但是，感知能力的决定因素确实因实践规模而异。在集体执​​业中，医师特征的影响在医师中更为明显，而在独奏/两位医师实践中，财务安排的影响对于医师而言是重要的。感知推荐能力的最重要决定因素是基层医疗医生与专家沟通的满意度。 nn结论：团体实践比单人/两位医生的实践更能不受托管医疗合同的外部财务安排的影响，这可能是因为它们有能力利用规模经济并分散其资金来源。

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  • 来源
    《Journal of Health Services Research & Policy》 |2002年第3期|p.143-150|共8页
  • 作者

    Tom Xu James Rohrer and Tyrone Borders;

  • 作者单位

    Texas Tech University Health Sciences Center, Department of Health Services Research and Management, Lubbock, Texas, USA;

    Texas Tech University Health Sciences Center, Department of Health Services Research and Management, Lubbock, Texas, USA;

    Texas Tech University Health Sciences Center, Department of Health Services Research and Management, Lubbock, Texas, USA;

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  • 正文语种 eng
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  • 关键词

    managed care;

    机译：管理式医疗;

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