title: A prospective evaluation of the effect of managed care on medical care utilization among severely disabled independently living adults.
abstract: We conducted an 18-month longitudinal evaluation of a model-managed medical care program for severely disabled, independently living adults. Regression analyses using an additive model (no interaction effects) suggest that persons in the study group did not have statistically significantly different utilization experiences than members of the comparison group. Regression analyses that include interaction effects suggest that, for certain segments of the cohort, the study group's utilization experience was significantly lower than that of members of the comparison group. Persons in the study group with higher baseline emergency room (ER) utilization had significantly fewer hospital admissions (P = 0.0055). The participants with better self-assessments of health experienced significantly fewer hospital days per person (P = 0.0075) and days per person hospitalized (P = 0.0056), and persons with organizational affiliations reported significantly fewer ER visits (P = 0.0264).
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D001900:Boston; D003695:Delivery of Health Care; D006233:Persons with Disabilities; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006304:Health Status; D006760:Hospitalization; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008329:Managed Care Programs; D012044:Regression Analysis; D012944:Social Support