A multilevel modelling approach to analysis of patient costs under managed care
研究采用多层次模型分析管理式医疗渗透率对患者成本的影响，基于美国退伍军人健康管理局24个医疗中心的数据，发现控制患者特征后机构间绩效差异不大，高渗透率机构更能控制重症患者成本。
The growth of the managed care model of health care delivery in the USA has led to broadened interest in the performance of health care providers. This paper uses multilevel modelling to analyse the effects of managed care penetration on patient level costs for a sample of 24 medical centres operated by the Veterans Health Administration (VHA). The appropriateness of a two level approach to this problem over ordinary least squares (OLS) is demonstrated. Results indicate a modicum of difference in institutions' performance after controlling for patient effects. Facilities more heavily penetrated by the managed care model may be more effective at controlling costs of their sicker patients.