Cost and Utilization: Hospitalized Patients on a Family Medicine Service

Area of Science:

• Health Economics
• Healthcare Management
• Health Services Research

Background:

• Rising hospitalization costs are a significant concern in US healthcare.
• Health insurance expansion is proposed as a cost-reduction strategy.
• This strategy's effectiveness depends on disproportionately high costs for uninsured individuals.

Purpose of the Study:

• To compare hospitalization utilization and costs for uninsured patients versus those with Medicaid and commercial insurance.
• To inform strategies for reducing healthcare expenditures.

Main Methods:

• Retrospective chart review of inpatient admissions.
• Analysis of data from a 290-bed community hospital over a 2-year period.
• Comparison of length of stay, emergency department visits, readmission rates, and mean charges based on insurance status.

Main Results:

• Medicaid patients exhibited significantly longer lengths of stay and higher readmission rates compared to uninsured and commercially insured patients.
• Variable costs were also significantly higher for the Medicaid population.
• Diagnosis-related group comparisons indicated higher average lengths of stay for Medicaid patients.

Conclusions:

• Insurance status significantly impacts hospital charges and utilization.
• Medicaid patients incurred the highest hospitalization costs.
• Transitioning uninsured individuals to Medicaid may not yield substantial reductions in hospitalization expenses.