Comparison of End of Life Costs Between Managed Care and Fee for Service

这项研究的目的是(1)确定管理保健、服务收费和医疗保险治疗的患者在过去一年中的比较成本和资源利用情况；(2)比较死亡地点；(3)比较临终关怀和医院床位的利用情况；(4)比较为65岁以上和65岁以下的患者提供的护理。从两家管理型医疗保健公司和联邦医疗保险获得了一整套数据。这些数据集的一些问题是，临终关怀的使用在一个数据集中没有完全记录，在死亡前的住院在另一个数据集中没有完全记录。然而，初步观察表明：(1)管理式医疗与死亡地点的服务费用(即医院与家庭)之间没有区别；(2)管理式医疗的癌症死亡比例略高于心脏病死亡。全部结果预计将在未来12个月内公布。

This study is designed (1) to determine the comparative costs and resources utilization over the last year of life for patients treated by managed care, fee-for-service, and Medicare, (2) to compare sites of death, (3) to compare utilization of hospice and hospital beds, and (4) to compare care provided to those over 65 and those under 65. A full set of data has been obtained from two managed care companies and from Medicare. Some problems with the data sets are that use of hospice is not fully recorded in one data set and hospitalization prior to death is not fully recorded in another. However, preliminary observations indicate (1) no difference between managed care and fee for service in site of death (i.e., hospital versus home) and (2) managed care has a slightly higher proportion of cancer deaths than deaths from heart disease. Full results are expected within the next 12 months.