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与全体会员相比,健康维护组织(HMO)退出者的人口统计学特征和既往使用经验。

Demographic characteristics and prior utilization experience of HMO disenrollees compared with total membership.

作者信息

Wersinger R P, Sorensen A A

出版信息

Med Care. 1982 Dec;20(12):1188-96. doi: 10.1097/00005650-198212000-00005.

Abstract

In the 2 months immediately after a premium rate increase, the Genesee Valley Group Health Association (Group Health) lost over 600 subscriber contracts. A survey was conducted to determine the reasons for disenrollment and compare the demographic and utilization characteristics of disenrollees with those of all members during the previous calendar year. The disenrollees were members of smaller families and were concentrated in a younger adult age group (15 to 35 years). The disenrollee ambulatory utilization rate was 14.5 per cent lower than for all members and their inpatient utilization (days/1,000) rate was 35 per cent lower. While maternity/nursery days were higher for disenrollees, medical/surgical days were 56 per cent lower. Age-adjusted medical/surgical days were 63.9 per cent lower. Although there was concern about possible adverse effects of a rate increase, the 1980 group Health inpatient utilization rates were virtually the same as for 1979, the year before the rate increase studied.

摘要

在保费提高后的紧接着两个月内,杰纳西河谷集团健康协会(集团健康)失去了600多个订阅者合同。进行了一项调查以确定退保原因,并将退保者的人口统计学和使用特征与上一历年所有会员的特征进行比较。退保者来自较小的家庭,集中在较年轻的成年年龄组(15至35岁)。退保者的门诊使用率比所有会员低14.5%,住院使用率(每1000人住院天数)低35%。虽然退保者的产科/托儿所天数较高,但医疗/手术天数低56%。年龄调整后的医疗/手术天数低63.9%。尽管人们担心费率提高可能产生的不利影响,但1980年集团健康的住院使用率与1979年(即研究费率提高前的那一年)几乎相同。

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