Objectives: This paper examines the effect of HMO market development on hospital utilization in short term general hospitals in the U.S. between 1985 and 1993.
Research
Design: Fixed effects regression models were estimated to compute
elasticities and changes in levels of seven different measures of hospital
utilization with unit change in HMO penetration and number of HMOs.
Hospital utilization measures were also forecast for the entire U.S.,
California and Pennsylvania at various hypothetical HMO levels: at 1985
levels, 1995 levels, California levels and Pennsylvania levels.
Finally, using the estimates from regression coefficients, factor
decomposition was performed to measure changes in the dependent variables
between 1985 and 1993 that can be attributed to changes in the explanatory
variables.
Measures: Inpatient days per capita, outpatient visits per capita, (log of) occupancy rate, (log of) beds per capita, (log of) admissions per capita, ratio of admissions to outpatient visits, and ratio of inpatient days to outpatient visits per 365 days.
Results & Conclusion: Among seven measures of hospital utilization, the association between inpatient days per capita and variation in HMO penetration is the strongest, and even for that measure, just 21% of the 9% decrease in inpatient days is attributable to HMOs. The association between HMO penetration and other utilization measures is even smaller. The results suggest that change in hospital utilization over the period 1985 to 1993 was attributable more to factors such as technological change than directly to HMOs.
Learning Objectives:
Keywords: Health Care Managed Care, Utilization
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.