Abstract
In a study of 300 chronically ill patients who were referred from an outpatient department to community health centers in a public hospital district, we found that the number of visits made, the amount of medicine prescribed, and the number of tests ordered all increased markedly for those patients in the 6 months immediately following their referral. As a result, there was substantial increase in the charges incurred for their care. The care itself changed as well. The physicians at the centers on the whole differed from those at the hospital in the emphasis they placed upon various types of visits, medicines, and tests. There were also large differences among the community health centers along these dimensions. The findings indicate the difficulty of providing comparable care at a comparable cost within a large health care system.
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Selected References
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- Freeborn D. K., Baer D., Greenlick M. R., Bailey J. W. Determinants of medical care utilization: physicians' use of laboratory services. Am J Public Health. 1972 Jun;62(6):846–853. doi: 10.2105/ajph.62.6.846. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Hirschhorn N. H., Lamstein J., Klein S. F., McCormack J., Warner T. N. Quality by objectives: a model of quality of care assessment and assurance for ambulatory health centers. J Ambul Care Manage. 1978 Jan;1(1):55–73. doi: 10.1097/00004479-197801000-00006. [DOI] [PubMed] [Google Scholar]
- Kronenfeld J. J. Provider variables and the utilization of ambulatory care services. J Health Soc Behav. 1978 Mar;19(1):68–76. [PubMed] [Google Scholar]
- Schroeder S. A., Kenders K., Cooper J. K., Piemme T. E. Use of laboratory tests and pharmaceuticals. Variation among physicians and effect of cost audit on subsequent use. JAMA. 1973 Aug 20;225(8):969–973. [PubMed] [Google Scholar]
- Skinner T. J., Price B. S., Gorry G. A. Directing the hospital outpatient to the neighborhood health clinic. Am J Public Health. 1977 Dec;67(12):1191–1193. doi: 10.2105/ajph.67.12.1191. [DOI] [PMC free article] [PubMed] [Google Scholar]