代表性的代价:急诊科护理中的保险状况、性别与心脏结局

The Cost of Representation: Insurance Status, Gender, and Cardiac Outcomes in Emergency Department Care

Public Administration Review · 2021
被引 15
ABS 4★

中文导读

研究了急诊科中医生与患者性别匹配对心脏结局的影响,发现公共保险不阻碍女性代表性,但无保险女性未从性别匹配中获益。

Abstract

Abstract Recent innovations in representative bureaucracy push the theory toward the micro‐foundations of who represents and who receives representation. Contributing to the micro theory, I draw from street‐level bureaucracy which recognizes how certain client characteristics beyond a shared identity may make representation too costly. Using data on emergency department visits to Florida hospitals, I explore how the impact of physician‐patient gender matching on client outcomes is moderated by a patient's insurance status. While emergency departments offer universal, public access, services performed on publicly insured and uninsured individuals are reimbursed at a lower rate than the privately insured. These features present an opportunity to test how responsive representation is to different client costs and benefits. The findings suggest that public insurance status is not a barrier for women's representation. However, uninsured women do not see any improvement in outcomes when receiving representation.

代表性官僚制急诊医疗健康保险性别匹配医疗结局