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Studying the effects of health plan competition: are available data resources up to the task?

机译:研究卫生计划竞争的影响:可用数据资源能否完成任务?

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摘要

OBJECTIVES: To review the availability of data sources to study health plan competition in the United States. DATA SOURCES: The literature on health plan competition was reviewed. Possible data sources to study health plan competition were evaluated. Experts in the field of health plan competition were contacted about their knowledge of existing data sources. Principal Findings. There is much more quantitative data available on HMO plans than on other types of health plans that are growing in popularity, such as PPOs. A key source for health plan data, state health insurance filings, lacks information on beneficiaries in non-HMO plans. Data on health plan quality is growing. In addition, case studies of particular markets is providing useful qualitative information on the dynamics of the health plan industry. CONCLUSIONS: The fragmentation of the health care market and the hesitancy of governments and private organizations to provide detailed information across markets and providers creates serious obstacles to the study of health plan competition.
机译:目的:审查数据源的可用性,以研究美国的健康计划竞争。数据来源:回顾了有关健康计划竞争的文献。评估了研究卫生计划竞争的可能数据来源。与健康计划竞争领域的专家联系,了解他们对现有数据源的了解。主要发现。 HMO计划提供的定量数据要比其他流行的健康计划(如PPO)多得多。卫生计划数据的重要来源是州健康保险备案,但缺乏有关非HMO计划受益人的信息。有关卫生计划质量的数据正在增长。此外,针对特定市场的案例研究正在提供有关健康计划行业动态的有用的定性信息。结论:医疗保健市场的分散以及政府和私人组织对在整个市场和提供者之间提供详细信息的犹豫不决,给研究医疗计划竞争构成了严重障碍。

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