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保险范围对健康维护组织(HMO)酗酒治疗项目的使用、治疗结果及医疗服务利用的影响。

Effect of coverage on use of an HMO alcoholism treatment program, outcome, and medical care utilization.

作者信息

Hayami D E, Freeborn D K

出版信息

Am J Public Health. 1981 Oct;71(10):1133-43. doi: 10.2105/ajph.71.10.1133.

Abstract

Two-hundred-fifty alcoholics were randomly assigned to a full benefit of 50 per cent copayment group before entering an HMO (health maintenance organization) alcoholism treatment program. Data on use of treatment services, use of medical care services, and drinking behavior were collected for one year after intake. The medical care utilization and drinking behavior data were compared to data for the year before intake. The two coverage groups were comparable on sociodemographic characteristics and baseline drinking behavior, but the full benefit group tended to have higher utilization rates for the year prior to intake and significantly more treatment contracts than those having the 50 per cent copayment requirement. Changes in use of medical care services were similar in both groups. Both payment groups improved, but the full benefit group tended to be somewhat more improved. Regression analysis supported the relative unimportance of extent of alcoholism coverage in affecting outcome and subsequent medical care utilization.

摘要

250名酗酒者在进入健康维护组织(HMO)的酗酒治疗项目之前,被随机分配到自付费用为50%全额补贴组。在入院后一年内收集了治疗服务使用情况、医疗服务使用情况和饮酒行为的数据。将医疗服务利用情况和饮酒行为数据与入院前一年的数据进行了比较。两个保险组在社会人口统计学特征和基线饮酒行为方面具有可比性,但全额补贴组在入院前一年的利用率往往较高,且治疗合同明显多于有50%自付费用要求的组。两组医疗服务使用情况的变化相似。两个付费组都有改善,但全额补贴组的改善程度往往更大一些。回归分析支持了酗酒保险范围在影响治疗结果和后续医疗服务利用方面相对不重要的观点。

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