title: Do HMOs make a difference? Use of health services.
abstract: This study analyzes the effects of health maintenance organizations (HMOs) on the use of health services by the privately insured, nonelderly population. After controlling for population and location differences, HMOs increase physician visits, nonphysician practitioner visits, and total ambulatory visits by modest but significant margins, while shifting the mix of physician care from specialists to primary care physicians. HMOs also increase use of two preventive services: mammography screening and flu shots. Contrary to expectation, however, the study finds no significant differences between HMO and non-HMO enrollees in the use of hospital, surgery, and emergency room services.
authors.affiliation: Center for Studying Health System Change, Washington DC 20024-2512, USA.
authors.forename: H T
authors.initials: HT
authors.lastname: Tu
authors.forename: P
authors.initials: P
authors.lastname: Kemper
authors.forename: H J
authors.initials: HJ
authors.lastname: Wong
mesh_terms: D000328:Adult; D000553:Ambulatory Care / Q000706:statistics & numerical data; D002648:Child; D017047:Cost Sharing; D019538:Health Care Surveys; D006279:Health Maintenance Organizations / Q000592:standards* / Q000706:statistics & numerical data*; D006296:Health Services / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007252:Influenza Vaccines; D008327:Mammography / Q000706:statistics & numerical data; D011314:Preventive Health Services / Q000706:statistics & numerical data; D011320:Primary Health Care / Q000706:statistics & numerical data; D017149:Private Sector; D012111:Residence Characteristics / Q000706:statistics & numerical data; D016540:Smoking Cessation / Q000706:statistics & numerical data; D013514:Surgical Procedures, Operative / Q000706:statistics & numerical data; D014481:United States; D014600:Utilization Review
chemical_list: D007252:Influenza Vaccines