Lack of effect of an experimental prepaid group practice on utilization of surgical care

The utilization of surgical care in an experimental period group practice for a 3 year period is reported. In contrast to what was expected, prepaid enrollees used the same or more surgical care than did control enrollees. The same proportion of emergency, urgent, and nonurgent admissions, occurred in both groups. Likewise there was no difference in the proportion of various procedures often thought to be overutilized in the traditional medical care system. High quality of surgical care in the area where the study was conducted was considered the most likely explanation for failure to show differences in the prepaid growth practice. Few, if any, unnecessary operations were performed in either group studied. Thus, under the conditions of this study, no significant measurable effect on surgical utilization by a change in the method of medical care organization and payment could be demonstrated.