A Controlled Trial of the Effect of a Prepaid Group Practice on the Utilization of Medical Services
Rand Corporation, 1985 - Health insurance - 33 pages
Does a prepaid group practice deliver less care than the fee-for-service system when both serve comparable populations with comparable benefits? To answer this question, the authors randomly assigned a group of 1580 persons to receive care free of charge either from a fee-for-service physician of their choice (431 persons) or at the Group Health Cooperative (GHC) of Puget Sound (1149 persons). Another 733 persons who shared in the cost of their fee-for-service care, but were otherwise comparable to the first two groups, were studied to observe the effects of cost sharing. The rate of hospital admissions for both groups at GHC was about 40 percent less than in the free-care fee-for-service group (p
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95 percent Accept Refuse Accept admission rates age and sex analysis of variance Brook C. N. Morris characteristics e.g. charges chiropractic compared Comparison Controlled Trial cost sharing cost-sharing plans covariates CRVS units Duan equation errors in parentheses estimates fee-for fee-for-service physicians fee-for-service system four-part model Free Fee Free Fee-for-Service group Free Fee-for-Service plan free-care GHC and fee-for-service GHC Control group GHC Experimental group GHC groups Group Health Cooperative Health Maintenance Organizations health status heteroscedasticity HMOs hospital days hospitalization rate imputed expenditure Individual Deductible plan inpatient services insurance plans intrafamily correlation J. E. Ware J. P. Newhouse linear regression Luft Mean Std Error medical expenses medical services out-of-plan percent less persons prepaid group practice present at enrollment preventive visits probit psychotherapy Rand Corporation random reduced Refuse Accept Refuse Rogers Seattle area significantly speech therapists Standard errors style of medicine subsample Table test statistic Tobit Model users variables