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Managed care linked to reduced hospital admission rates in California

In California, an increase in the penetration of managed care is associated with a reduction in hospital admission rates for outpatients with chronic health conditions, according to a UCSF study.

These results are among the first to suggest that managed care is linked with an improvement in primary care effectiveness, said Lisa Backus, MD, PhD, assistant clinical professor of medicine at the Palo Alto Veterans Administration, former UCSF fellow in general internal medicine at San Francisco General Hospital Medical Center (SFGHMC) and lead author of the study. The study appears in the April issue of the journal Medical Care.

The researchers noted that the cause of decreased hospitalizations remains unclear and should be addressed in future research. Assuming that decreases in hospitalization rates reflect better disease management strategies (one of the hallmarks of managed care), then managed care may have improved integration of inpatient and outpatient care, said Andrew Bindman, MD, UCSF professor of medicine, epidemiology and biostatistics and senior investigator on the study.

Reduced hospitalizations may result from the fact that care providers can monitor conditions like asthma, diabetes and hypertension more closely and prevent chronic conditions from getting serious enough to require hospitalization, he said. On the other hand, it is possible that managed care has achieved these benefits by simply raising the threshold for hospital admission.

The researchers explained that hospitalization rates have become a standard benchmark by which researchers can analyze the effectiveness of primary care. Previous studies have shown that Medicaid patients who had more continuity of care with a regular provider had lower rates of hospitalization for chronic conditions. In other studies, hospitalization rates for conditions that can be treated on an outpatient basis have also been shown to be higher in physician workforce shortage areas an
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Contact: Maureen McInaney
mmcinaney@pubaff.ucsf.edu
415-476-2557
University of California - San Francisco
28-Mar-2002


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