An Analysis of the Use of Medicare Services by the Continuously Enrolled Aged
An Analysis of the Use of Medicare Services by the Continuously Enrolled Aged
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连续参保老年人医保服务利用情况分析
DOI：
10.1097/00005650-198306000-00001
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发表时间：
1983
期刊：
影响因子：
3
通讯作者：
H. S. Wai
中科院分区：
文献类型：
--
作者：
N. McCall;H. S. Wai
本文讨论了连续参加该计划超过 4 年的老年人的医疗保险利用模式。本研究使用的数据来自科罗拉多州医疗保险受益人的随机样本，这些受益人从 1974 年 10 月到 1978 年 12 月连续登记。本文检查了五个利用变量：医疗办公室就诊次数、医疗相对价值单位 (RVU)、手术 RVU、住院天数和承保金额。这项研究的结果与之前的纵向分析一致。我们发现，服务的持续高用户消耗了总支出的很大一部分，而非用户则始终没有或很少有服务。据观察，在这 4 年期间的平均年份中，18% 的受益人占所提供服务成本的 88%。因为随着时间的推移，这些高用户往往会保持高用户状态——某一年超过三分之一的高用户在下一年继续是高用户——这里的研究结果表明，针对这些高用户的成本控制策略可能会对总体医疗保险计划成本产生重大影响。本文还进行了多变量分析，以便可以检查随时间变化的利用模式的决定因素。特别有趣的是，我们发现季节性和趋势变量在决定一段时间内的利用率方面发挥着重要作用。
This article discusses the utilization patterns of the Medicare aged who were continuously enrolled in the program for over a 4-year period. Data used for this study were compiled from a random sample of Medicare beneficiaries in Colorado who were continuously enrolled from October 1974 through December 1978. Five utilization variables: medical office visits, medical relative value units (RVUs), surgical RVUs, inpatient days, and covered dollars were examined in the article. Results from this study are consistent with previous longitudinal analyses. Consistent high users of services who consume substantial proportions of total expenditures and consistent nonusers having no or few services were found. During an average year of the 4-year period, it was observed that 18 per cent of the beneficiaries accounted for 88 per cent of the cost of services delivered. Because these high users tend to remain high users over time—more than one third of the high users in a given year continue to be high users during the following year—the findings here suggest that costcontainment strategies targeted to these high users may have a strong impact on overall Medicare program costs. Multivariate analysis is also conducted in this article so that the determinants of utilization patterns over time could be examined. Of particular interest is the finding that seasonal and trend variables play an important role in determining utilization over time.