PMID: 2497713May 1, 1989Paper

A comparison of length of stay and costs for health maintenance organization and fee-for-service patients

Archives of Internal Medicine
R S SternA M Epstein

Abstract

Enrollees of health maintenance organizations (HMOs) are less frequently hospitalized than are patients cared for by fee-for-service physicians. To determine if care provided to HMO and fee-for-service patient is different once they are hospitalized, we compared length of stay, total costs, and severity of illness for 617 HMO and fee-for-service patients hospitalized during the period 1983 through 1985 at a major teaching hospital. Severity was gauged in the following two ways: the Severity of Illness Index developed by Horn, and ratings by two physicians who were given all records from the first day of each patient's hospitalization. Length of stay was shorter and total costs were less for HMO patients in 7 of 11 diagnosis related groups. Using regression analysis to adjust for age, sex, emergency ward admission, diagnosis related group, and severity, we found that overall length of stay was 14% shorter for HMO patients than for fee-for-service patients (6.2 vs 5.3 days, P less than .01), whereas total costs were only 4% less ($4251 vs $4090, P greater than .2). These findings indicate that while patterns of utilization may vary by diagnosis related groups, HMO patients had shorter lengths of stay but comparable overall costs....Continue Reading

Citations

Feb 1, 1997·American Journal of Public Health·B ExpertonD M Mellon-Lacey
Sep 16, 2006·American Journal of Respiratory and Critical Care Medicine·Allan GarlandAlfred F Connors
Jun 11, 2005·Chest·Allan Garland
Apr 21, 2006·Health Policy·Anne FrølichR Adams Dudley
May 1, 1995·Clinical Nursing Research·D S Brown
Dec 6, 2000·Medical Care Research and Review : MCRR·F J Hellinger, H S Wong
Jun 1, 1997·Medical Care Research and Review : MCRR·T Fama, A Bernstein
Nov 1, 2000·Critical Care Medicine·A L RosenbergW A Knaus

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