title: Membership duration and utilization rates in a prepaid group practice.
abstract: The relationship between utilization rates and duration of membership in prepaid group practices can have important implications for national policy and HMO administration. The results of this study demonstrate a substantial reduction in utilization rates with increasing duration of membership over a 5-year period in a developing prepaid group practice (PGP) located in urban St. Louis. This "start-up effect" is strongly evident across different socioeconomic subgroupings of the study population (sex, race, income, education and age) and for different employers and cohorts. The implications of widespread start-ups for health care financing policy and for important PGP management decisions are discussed, and suggestions are made for future study of the start-up phenomenon.
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D005260:Female; D006123:Group Practice / Q000706:statistics & numerical data*; D006125:Group Practice, Prepaid / Q000706:statistics & numerical data*; D006264:Health Benefit Plans, Employee / Q000706:statistics & numerical data; D006279:Health Maintenance Organizations / Q000706:statistics & numerical data*; D006291:Health Policy; D006801:Humans; D008297:Male; D008875:Middle Aged; D008923:Missouri; D012737:Sex Factors; D012959:Socioeconomic Factors; D013997:Time Factors; D014481:United States