MARC record from Internet Archive

LEADER: 06250cam 2200625Ia 4500
001 ocm12990861
003 OCoLC
005 20210305064316.0
008 860108s1985 caua b 000 0 eng d
040 $aYML$beng$cYML$dIXA$dUMM$dNLM$dOCL$dOCLCQ$dOCLCO$dOCLCQ$dOCLCA$dOCLCF$dOCLCQ$dOCLCO$dOCLCQ$dIAD$dHDC$dOCLCA$dTXI$dOCLCO
016 7 $a9433381$2DNLM
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035 $a(OCoLC)12990861$z(OCoLC)25079557$z(OCoLC)31012859$z(OCoLC)31105414
043 $an-us---$an-us-wa
050 4 $aHG9396$b.M3665 1985
050 14 $aAS36$b.R3 R-3029
060 00 $aW 275 AW2
082 04 $a614.02$bR 186
100 1 $aManning, Willard G.,$cJr.$q(Willard Graham),$d1946-2014,$eauthor.$4aut
245 12 $aA controlled trial of the effect of a prepaid group practice on the utilization of medical services /$cWillard G. Manning [and others].
260 $aSanta Monica, CA :$bRand Corp.,$c1985.
300 $a33 pages :$billustrations ;$c23 cm.
336 $atext$btxt$2rdacontent
337 $aunmediated$bn$2rdamedia
338 $avolume$bnc$2rdacarrier
490 1 $a[Report] - Rand Corporation ;$vR-3029-HHS.
490 1 $aHealth insurance experiment series
490 1 $aRand publication series
504 $aIncludes bibliographical references (pages 31-33).
505 0 $aPreface -- Summary -- Acknowledgments -- Tables -- Introduction -- Methods -- Design Of The Trial -- Analytical Methods -- Measurement Of Use -- Results -- Discussion -- The Literature On Prepaid Group Practice -- The Lower Hospitalization Rate At GHC -- How Many Dollars Would Be Saved If HMO Enrollment Increased? -- Policy Implications -- Appendix: Statistical Methods -- References.
520 $aThis report compares people's utilization of health services under a prepaid group practice plan with that under fee-for-service. The work was undertaken as a part of the Rand Health Insurance Experiment, a large-scale social experiment designed to investigate the effects of health insurance plans on utilization of health services and health status. Other Rand reports based on this experiment also deal with the demand for health services: J. P. Newhouse, W. G. Manning, C. N. Morris, et al., Some Interim Results from a Controlled Trial of Cost Sharing in Health Insurance, R-2847-HHS, January 1982; N. Duan, W. G. Manning, C. N. Morris, and J. P. Newhouse, A Comparison of Alternative Models for the Demand for Medical Care, R-2754-HHS, January 1982; E. B. Keeler, J. E. Rolph, N. Duan, et al., The Demand for Episodes of Medical Treatment: Interim Results from the Health Insurance Experiment, R-2829-HHS, December 1982. These reports discuss the initial fee-for-service results of the study and discuss the statistical problems to be faced in estimating the demand for medical care. The present report should be of interest to persons studying the use of medical services and the organization of medical care. An abridged version of this report was published in the New England Journal of Medicine, June 7, 1984
520 $aDoes a prepaid group practice deliver less care than the fee -for service system when both serve comparable populations with comparable benefits? To answer this question, we randomly assigned a group of 1580 persons to receive care free of charge either from a fee-forservice physician of their choice (431 persons) or at the Group Health Cooperative of Puget Sound, or GHC (1149 persons). Another 733 prior enrollees of the GHC were studied as a control. Additionally, 782 persons who shared in the cost of their fee -for -service care, but were otherwise comparable to the first two groups, were studied to observe the effects of cost sharing. The rate of hospital admissions for both groups at GHC was about 40 percent less than in the free-care fee-for -service group (p < 0.01), although ambulatory visit rates were similar. The calculated expenditure rate for all services was about 25 percent less in the two GHC groups when compared with the free-care fee-for -service group (p < 0.01 for the experimental group, p < 0.05 for the control group). Preventive visits were higher in the prepaid groups, but cannot explain the reduced hospitalization. The similarity of utilization between the two prepaid groups implies that the mix of health-risks at GHC was similar to that in the fee-for -service system. Cost sharing, if sufficiently large, could reduce the total use of care in fee -for-service to the level of that observed at GHC, but the pattern of use was quite different. Cost sharing reduced both ambulatory visits and hospital admissions, whereas GHC did not reduce visits, but reduced admissions an insignificantly greater amount. The lower rate of use that we observed at GHC, along with comparable reductions found in noncontrolled studies by others, suggests that the style of medicine at prepaid group practices is markedly less hospital intensive and consequently less expensive.
650 0 $aHealth insurance$zUnited States.
650 12 $aHealth Maintenance Organizations$xstatistics & numerical data.$0https://id.nlm.nih.gov/mesh/D006279Q000706
650 22 $aCost Sharing.$0https://id.nlm.nih.gov/mesh/D017047
650 22 $aFees, Medical.$0https://id.nlm.nih.gov/mesh/D005251
650 22 $aHospitalization.$0https://id.nlm.nih.gov/mesh/D006760
651 2 $aWashington.$0https://id.nlm.nih.gov/mesh/D014861
650 7 $aHealth insurance.$2fast$0(OCoLC)fst01715839
651 7 $aUnited States.$2fast$0(OCoLC)fst01204155
710 2 $aRand Corporation.
710 1 $aUnited States.$bDepartment of Health and Human Services.
776 08 $iOnline version:$aRand Corporation.$tControlled trial of the effect of a prepaid group practice on the utilization of medical services.$dSanta Monica, CA : Rand Corp., 1985$w(OCoLC)614948191
830 0 $aR (Rand Corporation) ;$vR-3029-HHS.
830 0 $aHealth insurance experiment series.
830 0 $aRand publication series.
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029 1 $aAU@$b000024963498
029 1 $aGBVCP$b013719432
029 1 $aNLM$b9433381
029 1 $aNZ1$b3135407
994 $aZ0$bP4A
948 $hNO HOLDINGS IN P4A - 99 OTHER HOLDINGS