Miller M E, Gengler D J
Urban Institute, Washington, DC 20037.
Health Care Financ Rev. 1993 Fall;15(1):55-69.
Since 1981, States have been experimenting with Medicaid managed care programs to improve access and continuity of care and to contain costs by reducing inappropriate and unnecessary utilization. To determine the impact of primary care case management (PCCM) on utilization, the authors examine data from the Kentucky Patient Access and Care program (KenPAC). Using monthly utilization data from 1984 to 1989 and an interrupted time-series research design, the authors find that PCCM reduces the use of independent laboratory, physician, emergency department, and outpatient hospital services. PCCM does not appear to affect utilization of inpatient hospital services or prescription drugs.
自1981年以来，各州一直在试验医疗补助管理式医疗计划，以改善医疗服务的可及性和连续性，并通过减少不适当和不必要的医疗服务使用来控制成本。为了确定初级保健病例管理（PCCM）对医疗服务使用的影响，作者研究了肯塔基州患者就医机会与护理计划（KenPAC）的数据。作者利用1984年至1989年的月度医疗服务使用数据以及中断时间序列研究设计发现，PCCM减少了独立实验室、医生、急诊科和门诊医院服务的使用。PCCM似乎并未影响住院医院服务或处方药的使用。
