The impact of payor/provider type on health care use and expenditures among the frail elderly
Bibliographic Data
| ID | 11037592 |
|---|---|
| Authors | Bettina Experton (Trex (United States)), Z Li (0000-0003-2597-1092), Laurence G Branch, R J Ozminkowski, D M Mellon-Lacey |
| Year | 1997 |
| Volume | 87 |
| Issue | 2 |
| Pages | 210-216 |
| Publication date | 1997-02-01 |
| Peer Reviewed | Yes |
| Open Access | No |
| Type | ARTICLE |
| Venue | American Journal of Public Health (JOURNAL) |
| Journal identifiers | ISSN: 0090-0036 • E-ISSN: 1541-0048 |
| Publisher | American Public Health Association (PUBLISHER • US) |
| DOI | 10.2105/ajph.87.2.210 |
| PMID | 9103099 |
| OpenAlex | W2014689567 |
| Language | EN |
| Citations received | 2 |
| References cited | 12 |
OBJECTIVES: This study examined whether health care expenditures and usage by the frail elderly differ under three payor/provider types: Medicare fee for service, Medicare health maintenance organization (HMO), and dual Medicare-Medicaid enrollment. METHODS: In-home interviews were conducted among 450 frail elderly patients of a San Diego, Calif, health care system. Cost and use data were collected from providers. RESULTS: Analyses revealed no difference in total expenditures between fee-for-service and HMO enrollees, but Medicare-Medicaid beneficiaries' expenditures were 46.8% higher than those for HMO enrollees and 52.2% higher than those for the fee-for-service group. Fee-for-service participants were less than half as likely as HMO enrollees to have two or more hospital admissions, but hospital usage rates between those two payor/provider groups did not differ. Not were there payor/provider differences in access to home health care, but HMO home health care users received significantly fewer services than the others. CONCLUSIONS: The care provided to these HMO beneficiaries resulted in a combination of restricted home health use and higher multiple hospitalizations. This raises compelling questions for future research. For the dually enrolled, stronger cost containment may be required
Business · Family medicine · Fee-for-service · Health care · Health maintenance · Managed care · Medicaid · Service (business) · Geriatric Care and Nursing Homes · Global Health Care Issues · Healthcare Policy and Management · Medicine · Gerontology
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| Unique citing works | 2 |
|---|---|
| Citations per year | 0,07 |
| Citation span | 1999 - 2024 (26) |
| Citation velocity | recent |
| Highly cited | No |
| Citation types | Neutral: 2 |