Abstract
National survey data were used to describe and analyze the treatment of selected illnesses: hypertension, heart condition, hernia, gynecological infection, menstrual disorder, other gynecological conditions, pneumonia, and urinary tract infection. The number of office visits, the rate of diagnostic testing, the average charge, and the use of inpatient and outpatient hospital services were analyzed in an econometric model of treatment. Differences in the treatment of patients with similar illnesses were associated with comprehensive insurance, the availability of hospital and physician resources, and other economic considerations. There was also evidence that hospital and ambulatory services were substituted for each other, as a result of economic as well as medical considerations.
Full text
PDF
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Brook R. H., Ware J. E., Jr, Rogers W. H., Keeler E. B., Davies A. R., Donald C. A., Goldberg G. A., Lohr K. N., Masthay P. C., Newhouse J. P. Does free care improve adults' health? Results from a randomized controlled trial. N Engl J Med. 1983 Dec 8;309(23):1426–1434. doi: 10.1056/NEJM198312083092305. [DOI] [PubMed] [Google Scholar]
- Hadley J., Holahan J., Scanlon W. Can fee-for-service reimbursement coexist with demand creation? Inquiry. 1979 Fall;16(3):247–258. [PubMed] [Google Scholar]
- Hershey J. C., Luft H. S., Gianaris J. M. Making sense out of utilization data. Med Care. 1975 Oct;13(10):838–854. doi: 10.1097/00005650-197510000-00004. [DOI] [PubMed] [Google Scholar]
- McPherson K., Wennberg J. E., Hovind O. B., Clifford P. Small-area variations in the use of common surgical procedures: an international comparison of New England, England, and Norway. N Engl J Med. 1982 Nov 18;307(21):1310–1314. doi: 10.1056/NEJM198211183072104. [DOI] [PubMed] [Google Scholar]
- Newhouse J. P., Manning W. G., Morris C. N., Orr L. L., Duan N., Keeler E. B., Leibowitz A., Marquis K. H., Marquis M. S., Phelps C. E. Some interim results from a controlled trial of cost sharing in health insurance. N Engl J Med. 1981 Dec 17;305(25):1501–1507. doi: 10.1056/NEJM198112173052504. [DOI] [PubMed] [Google Scholar]
- Sloan F. A. Access to medical care and the local supply of physicians. Med Care. 1977 Apr;15(4):338–346. doi: 10.1097/00005650-197704000-00009. [DOI] [PubMed] [Google Scholar]
- Wennberg J. E. Dealing with medical practice variations: a proposal for action. Health Aff (Millwood) 1984 Summer;3(2):6–32. doi: 10.1377/hlthaff.3.2.6. [DOI] [PubMed] [Google Scholar]
- Wennberg J. E., McPherson K., Caper P. Will payment based on diagnosis-related groups control hospital costs? N Engl J Med. 1984 Aug 2;311(5):295–300. doi: 10.1056/NEJM198408023110505. [DOI] [PubMed] [Google Scholar]
- Wennberg J., Gittelsohn A. Variations in medical care among small areas. Sci Am. 1982 Apr;246(4):120–134. doi: 10.1038/scientificamerican0482-120. [DOI] [PubMed] [Google Scholar]