Jm. Bronstein et al., IMPACT OF CARE SETTING ON COST AND QUALITY UNDER MEDICAID, Journal of health care for the poor and underserved, 8(2), 1997, pp. 202-213
Citations number
24
Categorie Soggetti
Social Work","Public, Environmental & Occupation Heath
Medicaid claims data were used to compare the costs and care quality o
f ambulatory visits for two childhood illnesses, urinary tract infecti
on (UTI) and suppurative otitis media (OM), in the fee-for-service Med
icaid program in Alabama across three care settings: offices where pat
ients had been seen before, offices where patients had not been seen b
efore, and outpatient hospital departments. Forty percent of UTI visit
s and 46 percent af OM visits occurred in return office settings. Visi
ts to outpatient hospital and first-time office settings were more exp
ensive than those to return office settings, due to the billing of fac
ility fees and the provision of additional services. Adherence to comm
on measures of quality of care for both types of visits was few; 52 pe
rcent of UTI visits included urine cultures and 40 percent of OM visit
s included recheck visits. Adherence to these quality measures was sig
nificantly lower in visits occuring in hospital settings.