Abstract
The amount of primary care provided at hospitals is increasing, yet little information exists on the relative costs of this form of care. To address this issue, we compared the treatment resources used by internists practicing in hospital-based and free-standing clinics. The study site was the Kaiser-Permanente Medical Care Program, Oregon Region. To control for case mix, the analysis focused on episodes of six specified conditions; upper respiratory infection, urinary tract infection, hypertension, abdominal pain, chest pain, and physical exam. The California Relative Value Schedule was used to define care intensity by summarizing the clinical, laboratory, and radiology services provided. Results indicate that setting exerts little influence on the intensity of primary care for the episodes studied; care of similar intensity is provided in hospital-based and free-standing settings.
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- Gold M. Hospital-based versus free-standing primary care costs. J Ambul Care Manage. 1979 Feb;2(1):1–20. doi: 10.1097/00004479-197902000-00002. [DOI] [PubMed] [Google Scholar]
- Kessner D. M., Kalk C. E., Singer J. Assessing health quality--the case for tracers. N Engl J Med. 1973 Jan 25;288(4):189–194. doi: 10.1056/NEJM197301252880406. [DOI] [PubMed] [Google Scholar]
- Lees R. E., Steele R., Spasoff R. A. Primary care for nontraumatic illness at the emergency department and the family physician's office. Can Med Assoc J. 1976 Feb 21;114(4):333–337. [PMC free article] [PubMed] [Google Scholar]
- Moscovice I. A method for analyzing resource use in ambulatory care settings. Med Care. 1977 Dec;15(12):1024–1044. doi: 10.1097/00005650-197712000-00006. [DOI] [PubMed] [Google Scholar]
- Roemer M. I., Shonick W. HMO performance: the recent evidence. Milbank Mem Fund Q Health Soc. 1973 Summer;51(3):271–317. [PubMed] [Google Scholar]
- Ross C. E., Duff R. S. Quality of outpatient pediatric care: the influence of physicians' background, socialization, and work/information environment on performance. J Health Soc Behav. 1978 Dec;19(4):348–360. [PubMed] [Google Scholar]
- Steele R., Lees R. E., Latchman B., Spasoff R. A. Cost of primary health care services in the emergency department and the family physician's office. Can Med Assoc J. 1975 May 3;112(9):1096-8, 1113. [PMC free article] [PubMed] [Google Scholar]
- Williams S. J., Shortell S. M., Dowling W. L., Urban N. Hospital-sponsored primary care group practices: a developing modality of care. Health Med Care Serv Rev. 1978 Sep-Dec;1(5-6):1, 3-13. [PubMed] [Google Scholar]