The growth of managed care and changes in physicians' incomes, autonomy, and satisfaction, 1991-1997

被引：32

作者：

Hadley J. ^{[1
]}

Mitchell J.M. ^{[2
]}

机构：

[1] The Urban Institute, Washington DC and Senior Fellow, Center for Studying Health System Change

[2] Public Policy Institute, Georgetown University

来源：

International Journal of Health Care Finance and Economics | 2002年 / 2卷 / 1期

基金：

美国医疗保健研究与质量局;

关键词：

Survey Data; Lower Income; Economic Policy; Public Finance; Financial Incentive;

D O I：

10.1023/A:1015397413797

中图分类号：

学科分类号：

摘要：

Using survey data collected in 1991 and 1997 from a panel of almost 1,500 physicians, we analyzed the relationship between changes in physicians' incomes, practice autonomy, and satisfaction, and the growth of HMOs and physicians' perceived financial incentives. Both the growth of HMOs and financial incentives to reduce services were significantly related to lower income growth, reductions in practice autonomy, and decreases in satisfaction. Changes in income and autonomy were both positively and significantly related to changes in satisfaction. Controlling for changes in income and autonomy, HMO growth was no longer significantly related to changes in satisfaction. Having a perceived financial incentive to reduce services remained a negative and significant determinant of the change in career satisfaction.

引用

页码：37 / 50

页数：13

共 67 条

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