Utilization, Costs, and Access to Primary Care in Fee-for-Service and Managed Care Plans
Utilization, Costs, and Access to Primary Care in Fee-for-Service and Managed Care Plans
复制标题
按服务收费和管理式医疗计划中初级保健的利用、成本和获取机会
DOI：
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发表时间：
2001
期刊：
影响因子：
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通讯作者：
J. Laditka
中科院分区：
文献类型：
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作者：
S. Laditka;J. Laditka
摘要 本研究比较了四种形式的管理式医疗和赔偿计划的参与者获得初级保健的机会、利用率和成本。我们使用商业保险公司 1996 年的数据。大多数管理式医疗参保者比赔偿参保者能更好地获得初级保健服务。这种访问与可预防的住院率普遍较低有关。管理式医疗计划的人均住院费用明显低于赔偿计划。我们描述了医疗保健管理者如何使用现成的管理数据和简单的统计技术来加强对质量和成本的日常监控。政策制定者可以使用这种方法来确定卫生服务趋势，并评估参加各种福利计划类型的个人获得卫生服务的情况。
Abstract This study compares access to primary care, utilization, and costs among enrollees in four forms of managed care and an indemnity plan. We use 1996 data from a commercial insurer. Most managed care enrollees had better access to primary care services than indemnity enrollees. This access was associated with a generally lower rate of preventable hospitalization. Per capita inpatient costs were notably lower in managed care plans than in the indemnity plan. We describe how health care managers can use readily available administrative data and straightforward statistical techniques to enhance routine monitoring for quality and costs. Policy makers can use this approach to identify health services trends, and to evaluate access to health services for individuals enrolled in various benefit plan types.
影响因子：
3.4
作者：
Flood,AB;Fremont,AM;Jin,K;Bott,DM;Ding,J;ParkerJr,RC
通讯作者：
ParkerJr,RC