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Health care utilization in HMO's. Results from two national samples
Journal of Health Economics
|November 6, 1985
Insights
Health Maintenance Organizations (HMOs) may reduce hospital days compared to traditional insurance. However, this study found imprecision in the data, requiring further investigation into HMO utilization and cost containment effectiveness.
Area of Science:
- Health Services Research
- Medical Economics
- Public Health Policy
Background:
- Health Maintenance Organizations (HMOs) are promoted for controlling healthcare expenditures.
- Previous research has not extensively utilized national datasets to evaluate HMO utilization patterns.
Purpose of the Study:
- To determine if HMOs lead to lower healthcare utilization compared to conventional insurance plans.
- To analyze the impact of HMO enrollment on hospital days using a national dataset.
Main Methods:
- Utilized a national dataset for comprehensive analysis.
- Employed regression and logit analyses to control for confounding variables.
- Controlled for demographic factors and patient health status to isolate HMO effects.
Main Results:
- Point estimates suggest HMOs reduce hospital days relative to conventional insurance (e.g., Blue Cross).
- Statistical imprecision was identified as a significant limitation in the findings.
- The study provides initial evidence on HMO utilization from a national perspective.
Conclusions:
- HMOs show a trend towards reduced hospital utilization, but further research is needed due to data limitations.
- The effectiveness of HMOs in cost containment warrants continued investigation with more precise data.
- Findings highlight the importance of robust data for evaluating healthcare delivery models.
Abstract:
HMO's have been endorsed as a means of containing medical care costs. This study is the first use of a national data set to analyze whether HMO's have lower utilization. Regression and logit analyses are used to control for demographic and health status variables. The point estimates confirm that HMO's cut hospital days relative to conventional insurance (e.g., Blue Cross), but imprecision is a serious problem.