Background and Methods The rate of conversion to for-profit ownership of hospitals has recently increased in the United States, with uncertain implications for health care costs.
We compared total per capita Medicare spending in areas served by for-profit and not-for-profit hospitals.
We used American Hospital Association data to categorize U.S. hospital service areas as for-profit (meaning that all beds in the area were in for-profit hospitals), not-for-profit (all beds were in not-for-profit hospitals), or mixed in 1989,1992, and 1995.
We then used data from the Continuous Medicare History Sample to calculate the 1989,1992, and 1995 spending rates in each area, adjusting for other characteristics known to influence spending : age, sex, race, region of the United States, percentage of population living in urban areas, Medicare mortality rate, number of hospitals, number of physicians per capita, percentage of beds in hospitals affiliated with medical schools, percentage of beds in hospitals belonging to hospital chains, and percentage of Medicare beneficiaries enrolled in health maintenance organizations.
Results Adjusted total per capita Medicare spending in the 208 areas where all hospitals remained under for-profit ownership during the study years was greater than in the 2860 areas where all hospitals remained under not-for-profit ownership ($4,006 vs. $3,554 in 1989, $4,243 vs. $3,841 in 1992, and $5,172 vs. $4,440 in 1995 ; P<0.001 for each comparison). (...)
Mots-clés Pascal : Hôpital, Privatisation, Dépense, Soin, Santé, Analyse coût, Organisation santé, Homme, Economie santé
Mots-clés Pascal anglais : Hospital, Privatisation, Expenditure, Care, Health, Cost analysis, Public health organization, Human, Health economy
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0419021
Code Inist : 002B30A04B. Création : 22/03/2000.