This study used two data sets, the 1998 Managed Care Digest data and the 1996 National Hospital Discharge Survey data. The first data set was used to examine HMO penetration in the four national geographical areas (South, Northeast, West, Midwest). The regional HMO penetration was calculated using each state rate. The second data set was used to compare differences in the average length of stay (LOS), which is used as a proxy for resource use, in the four regions. The average LOS was calculated for each of the four regions using the LOS for each hospitalization. Using ANOVA, the researchers found significant differences in HMO penetration and the average LOS across the four regions. Further analysis was performed using a OLS regression. The average LOS per hospitalization was used as a dependent variable in two models. The independent variables in the first model were payer, marital status, race, age, DRG (severity), and hospital characteristics (number of beds, type of ownership). All of the independent variables were significant in predicting LOS, explaining 26.73% of the variation. Additional regression models were calculated for each region. For-profit hospitals in the Northeast and Western regions, that also have the highest HMO penetration rates, had the lowest average LOS. In these two regions, hospitals with more than 200 beds, showed no significant difference in average LOS. HMO penetration reduces consumption of hospital resources as measured by LOS.
Learning Objectives: HMO penetration reduced consumption of hospital resources as measured by LOS. Hospitals tried to change their resource consumtion behavior to adapt to the HMO environment
Keywords: HMOs, Hospitals
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.
The 128th Annual Meeting of APHA