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Utilization of healthcare services among the near-elderly: A comparison of managed care and fee-for-service enrollees

Xiao Xu, MA and Gail A. Jensen, PhD. Institute of Gerontology, Wayne State University, 87 E. Ferry St., 226 Knapp Bldg., Detroit, MI 48202, (313)577-2297, xiao_xu@wayne.edu

OBJECTIVE: To analyze the effects of enrolling in a managed care plan (health maintenance organization (HMO) or preferred provider organization (PPO)) on use of healthcare services among near-elderly adults (ages 55-64). DATA AND METHODS: 3833 near-elders with employer-sponsored health insurance coverage were examined using the 1994 - 2000 waves of the Health and Retirement Study (HRS). Binary logistic regressions and two-part models were estimated for use of inpatient, outpatient, and preventive services. Possible selection bias into managed care plans was examined and tested for statistically, and multistage regressions were implemented whenever test results indicated its presence. RESULTS: Compared with near-elders enrolled in traditional fee-for-service (FFS) plans, HMO enrollees were 1.60 times more likely to visit a doctor, 1.22 times more likely to have a blood test for cholesterol and 1.32 times more likely to have a pap smear over a two-year period. Similarly, PPO enrollees were more likely to have outpatient surgery, a doctor visit, a blood test for cholesterol and a pap smear when compared with FFS enrollees (odds ratios of 1.29, 1.67, 1.49, and 1.32 respectively). There were no significant differences in the length of hospital stay, number of doctor visits, or the probability of a hospital stay, monthly self-checks for breast lumps, a mammogram, or a check for prostate cancer. CONCLUSION: Managed care enrollment was associated with greater use of primary care and preventive services among near-elders.

Learning Objectives: Through this poster session, participants will be able to

Presenting author's disclosure statement:
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.

Current Issues in Health and Health Care for Older Adults

The 132nd Annual Meeting (November 6-10, 2004) of APHA