Physician perceived market competition associated with barriers to delivery of quality care: Evidence from a national cross-sectional survey of physicians in the USA

摘要

While quality is of paramount concern in health care, there has been little research done examining physician attitudes towards quality of health care and their perceived competitiveness in the market place. Utilizing the national physician survey data (n = 4720), we undertook a bivariate and multivariate regression analysis to explore the association between physician perceived competition and barriersto quality of care. After adjusting personal and organizational factors, two quality care measures were found to be related to increased physician perceived market competition: (I) inadequate mechanism (patient's inability to pay for care); (2) variations in practice (medical errors and untimeliness of medical reports). Overall our findings suggest the association between perceived market competition and barriers to quality of care. In physicians' views the current managed care market system appears to be competitive but this market competition may not benefit practicing physicians in improving quality of patient care.