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Expenditures and Financial Incentives

Frank A. Sloan, PhD

JAMA. 1993;269(24):3155-3156.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

THE STUDY by Evans¹ in this issue of JAMA provides several important messages about organ transplantation policy, in particular about financial aspects of organ procurement. Evans documented historical rates of increase in organ procurement charges and the substantial variation among providers in such charges in a single year. Some of the intertemporal and cross-sectional variation probably reflects underlying variation in case mix and possibly variation in the technology, but it is plausible to regard other factors, such as methods of reimbursement and differences in efficiency of organ procurement organizations,² as causal influences. Evans did not assess determinants of variation in providers' charges for organ procurement. Such a study merits a high priority.

The primary rationale for paying providers on a retrospective cost or charge basis, here and in other health care contexts, was that health care services are inherently heterogeneous because of differences among patients and circumstances under . . . [Full Text PDF of this Article]

Author Affiliations
From the Department of Economics and Center for Health Policy Research and Education, Duke University, Durham, NC.

Footnotes
Reprint requests to the Center for Health Policy Research and Education, Duke University, Box 90253, Durham, NC 27708-1111 (Dr Sloan).

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