Harrington C, Newcomer R J, Preston S
Department of Social and Behavioral Sciences, University of California, San Francisco 94143-0612.
Inquiry. 1993 Winter;30(4):429-40.
Four Social/Health Maintenance Organization demonstration projects had disenrollment rates of about 8.6% annually during the first 36 months. This study compares those who disenrolled to those who remained S/HMO members. The analysis found that S/HMOs sponsored by HMOs had lower disenrollment than S/HMOs sponsored by long-term care organizations. The major reasons for disenrollment were dissatisfaction with physician services and premium costs. Having other insurance, not living alone, having inadequate information upon enrollment, having no physical impairments or health problems, and no use of hospital or chronic care were found to be positive predictors of disenrollment. Switching from the S/HMO to another HMO rather than to fee-for-service was associated with having no health problems, having no other health insurance, living alone, and being married.
四个社会/健康维护组织示范项目在最初的36个月里年退出率约为8.6%。本研究比较了退出者和仍为社会/健康维护组织成员的人。分析发现,由健康维护组织赞助的社会/健康维护组织的退出率低于由长期护理组织赞助的社会/健康维护组织。退出的主要原因是对医生服务和保费成本不满意。拥有其他保险、非独居、参保时信息不足、没有身体损伤或健康问题以及未使用医院服务或长期护理被发现是退出的积极预测因素。从社会/健康维护组织转向另一个健康维护组织而非转为按服务收费与没有健康问题、没有其他健康保险、独居和已婚有关。