The effect of managed care on health services use by dually eligible elders.

This study examined the effect of a managed-care demonstration program on use of health services by a dually eligible elderly population. Our analysis of utilization data generated from a survey of Medicaid-Medicare beneficiaries in two California counties revealed that utilization behavior of the two study groups did not differ significantly, with two exceptions. The beneficiaries in the demonstration group made more frequent visits to community health clinics and had longer stays in hospitals for medical procedures than did those in the comparison group. In modeling the determinants of health services use, we found that the relationship between ambulatory physician visits and hospitalization of the elderly was complementary rather than substitutive.