A comparison of the effects of sociodemographic factors and health status on use of outpatient mental health services in HMO and fee-for-service plans.
The authors compared the effects of age, sex, socioeconomic status, and mental and physical health status on the use of outpatient mental health services in one well-established health maintenance organization (HMO) and in fee-for-service plans. In the Seattle site of the Rand Health Insurance Study (HIS), families were randomly assigned to HMO or fee-for-service coverage. Adults incur much greater expense for outpatient mental health services than children in both an HMO and a fee-for-service plan with identical coverage (i.e., free care). However, the difference in use between adults and children is significantly greater for the fee-for-service plan than the HMO (P less than 0.01). Similarly, education has significantly greater effects on use for the fee-for-service than the HMO plan. Increased income has a significant negative effect on use in both the HMO and fee-for-service plans. Mental and physical health status have similar large effects on use in both fee-for-service and HMO plans.
D000328:Adult; D000367:Age Factors; D002648:Child; D003710:Demography; D005251:Fees, Medical; D005260:Female; D006262:Health; D006279:Health Maintenance Organizations / Q000706:statistics & numerical data*; D006304:Health Status; D006801:Humans; D007358:Insurance, Psychiatric / Q000706:statistics & numerical data*; D008297:Male; D008605:Mental Health Services / Q000706:statistics & numerical data*; D010045:Outpatients; D010361:Patients; D011897:Random Allocation; D012737:Sex Factors; D012959:Socioeconomic Factors; D013223:Statistics as Topic; D014861:Washington