title: Cost and Utilization: Hospitalized Patients on a Family Medicine Service.
abstract: OBJECTIVE
  The cost of hospitalizations contributes to the rising expense of medical care in the United States. Providing health insurance to uninsured Americans is a strategy to reduce these costs, but only if costs for uninsured patients are disproportionately high. This study examined hospitalization use patterns for uninsured patients compared with those with Medicaid and commercial insurance.
  
  
  METHODS
  We performed a retrospective chart review to analyze inpatient admissions to a family medicine teaching service in a 290-bed, for-profit community hospital during a 2-year period based on insurance status of the patient. Outcome variables investigated were length of stay, emergency department visits, and readmission rates to the hospital and/or emergency department. Secondary outcome variables were mean charges.
  
  
  RESULTS
  A total of 1102 admissions to a family medicine teaching service were evaluated. Length of stay, readmission rates to the hospital and the emergency department after hospital discharge, and average length of stay compared with diagnosis-related groups were significantly higher in the Medicaid population than for insured and uninsured individuals. Variable costs also were significantly higher.
  
  
  CONCLUSIONS
  Insurance status was found to be a significant factor in hospital charges and utilization data, with Medicaid patients having the highest costs. This suggests that moving uninsured patients to Medicaid may not significantly reduce hospitalization costs.
authors.affiliation: From the Department of Family Medicine, Medical University of South Carolina, Charleston, Trident Medical Center, Charleston, South Carolina, the Department of Family Medicine, Division of Administration, Medical College of Wisconsin, Milwaukee, and the Department of Community Health and Family Medicine, University of Florida, Gainesville.
authors.forename: Maribeth
authors.initials: M
authors.lastname: Porter
authors.affiliation: From the Department of Family Medicine, Medical University of South Carolina, Charleston, Trident Medical Center, Charleston, South Carolina, the Department of Family Medicine, Division of Administration, Medical College of Wisconsin, Milwaukee, and the Department of Community Health and Family Medicine, University of Florida, Gainesville.
authors.forename: Vanessa A
authors.initials: VA
authors.lastname: Diaz
authors.affiliation: From the Department of Family Medicine, Medical University of South Carolina, Charleston, Trident Medical Center, Charleston, South Carolina, the Department of Family Medicine, Division of Administration, Medical College of Wisconsin, Milwaukee, and the Department of Community Health and Family Medicine, University of Florida, Gainesville.
authors.forename: Jennifer K
authors.initials: JK
authors.lastname: Gavin
authors.affiliation: From the Department of Family Medicine, Medical University of South Carolina, Charleston, Trident Medical Center, Charleston, South Carolina, the Department of Family Medicine, Division of Administration, Medical College of Wisconsin, Milwaukee, and the Department of Community Health and Family Medicine, University of Florida, Gainesville.
authors.forename: Ashleigh
authors.initials: A
authors.lastname: Zacarias
authors.affiliation: From the Department of Family Medicine, Medical University of South Carolina, Charleston, Trident Medical Center, Charleston, South Carolina, the Department of Family Medicine, Division of Administration, Medical College of Wisconsin, Milwaukee, and the Department of Community Health and Family Medicine, University of Florida, Gainesville.
authors.forename: Lori
authors.initials: L
authors.lastname: Dickerson
authors.affiliation: From the Department of Family Medicine, Medical University of South Carolina, Charleston, Trident Medical Center, Charleston, South Carolina, the Department of Family Medicine, Division of Administration, Medical College of Wisconsin, Milwaukee, and the Department of Community Health and Family Medicine, University of Florida, Gainesville.
authors.forename: William J
authors.initials: WJ
authors.lastname: Hueston
authors.affiliation: From the Department of Family Medicine, Medical University of South Carolina, Charleston, Trident Medical Center, Charleston, South Carolina, the Department of Family Medicine, Division of Administration, Medical College of Wisconsin, Milwaukee, and the Department of Community Health and Family Medicine, University of Florida, Gainesville.
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Carek
mesh_terms: D000368:Aged; D003365:Costs and Cost Analysis; D005194:Family Practice; D005260:Female; D006760:Hospitalization / Q000191:economics*; D006801:Humans; D007902:Length of Stay; D016015:Logistic Models; D008297:Male; D008484:Medicaid / Q000191:economics*; D017057:Medically Uninsured / Q000706:statistics & numerical data*; D008875:Middle Aged; D014481:United States