Inpatient Hospital Utilization in Three Prepaid Comprehensive Health Care Plans Compared With a Regular Blue Cross Plan
Bibliographic Data
| ID | 9099039 |
|---|---|
| Authors | Richard Wersinger, Richard P Wersinger (General Department of Preventive Medicine, corresponding author), Klaus J Roghmann (General Department of Preventive Medicine, corresponding author), J William Gaveti (General Department of Preventive Medicine), Sandra M Wells |
| Year | 1976 |
| Volume | 14 |
| Issue | 9 |
| Pages | 721-732 |
| Publication date | 1976-09-01 |
| Open Access | No |
| Type | ARTICLE |
| Venue | Medical Care (JOURNAL) |
| Journal identifiers | ISSN: 0025-7079 • E-ISSN: 1537-1948 |
| Publisher | Ovid Technologies (Wolters Kluwer Health) (PUBLISHER) |
| DOI | 10.1097/00005650-197609000-00001 |
| PMID | 972565 |
| OpenAlex | W2070800433 |
| Language | EN |
| Citations received | 9 |
The evidence is substantial that comprehensive, HMO-type prepayment plans can significiantly reduce hospitalization rates. Yet it remains unclear which factors contribute to this phenomenon. This study focuses on organizational characteristics of four plans with different hospitalization experiences. Regular medical staff review and frequent use of second opinions and economies of scale achieved by providing care at one well-equipped, large health center appear to have the largest impact. However, such organizational advantages can easily be wiped out by adverse self-selection of patients during open-enrollment periods. Evidence of selection based on predictable high obstetrical and newborn care costs is presented
Actuarial science · Adverse selection · Business · Family medicine · Health care · Health plan · Medical emergency · Prepayment of loan · Scale (ratio) · Selection (genetic algorithm) · Finance · Geriatric Care and Nursing Homes · Healthcare Policy and Management · Medicine · Nursing · Primary Care and Health Outcomes
Mode of Payment as a Predictor of Health Status, Use of Health Services and Preventive Health Behavior
Are HMO Enrollees Being Attracted by a Liberal Maternity Benefit
Price and Membership in a Prepaid Group Medical Practice
Risk Selection of Families Electing HMO Membership
Demographic Characteristics and Prior Utilization Experience of HMO Disenrollees Compared With Total Membership
The Use of Health Services by Civilian Beneficiaries of the Military Health Care System A Comparative Study
The Use of Prenatal Cytogenetic Diagnosis
Section 8 attempts to control health care costs
Attempts to control health care costs
| Citations per year | 0.19 |
|---|---|
| Citation span | 1978 - 1986 (9) |
| Highly cited | No |