1. A prospective evaluation of the effect of managed care on medical care utilization among severely disabled independently living adults
- Author
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Allan R. Meyers, Ruth I. Lederman, Mary Glover, Laurence G. Branch, Robert J. Master, Doreen Nicastro, Denise Kress, Adrienne Cupples, and Marie Feltin
- Subjects
Adult ,Male ,medicine.medical_specialty ,Health Status ,Medical care ,Prospective evaluation ,Ambulatory care ,Critical care nursing ,Activities of Daily Living ,Medicine ,Humans ,Disabled Persons ,Longitudinal Studies ,Hospital days ,business.industry ,Managed Care Programs ,Public Health, Environmental and Occupational Health ,Social Support ,Hospitalization ,Cohort ,Emergency medicine ,Managed care ,Regression Analysis ,Organizational Affiliation ,Female ,business ,Emergency Service, Hospital ,Delivery of Health Care ,Demography ,Boston - Abstract
We conducted an 18-month longitudinal evaluation of a model-managed medical care program for severely disabled, independently living adults. Regression analyses using an additive model (no interaction effects) suggest that persons in the study group did not have statistically significantly different utilization experiences than members of the comparison group. Regression analyses that include interaction effects suggest that, for certain segments of the cohort, the study group's utilization experience was significantly lower than that of members of the comparison group. Persons in the study group with higher baseline emergency room (ER) utilization had significantly fewer hospital admissions (P = 0.0055). The participants with better self-assessments of health experienced significantly fewer hospital days per person (P = 0.0075) and days per person hospitalized (P = 0.0056), and persons with organizational affiliations reported significantly fewer ER visits (P = 0.0264).
- Published
- 1987