scholarly journals Understanding recent trends in Swiss ambulatory care utilization when out-of-pocket payment is minimal

2006 ◽  
Vol 51 (5) ◽  
pp. 318-322 ◽  
Author(s):  
I. Peytremann Bridevaux ◽  
B. Santos-Eggimann
2021 ◽  
Vol 126 (3) ◽  
pp. 203-215
Author(s):  
Kimberly G. Phillips ◽  
Jeanne S. Wishengrad ◽  
Andrew J. Houtenville

Abstract Inpatient hospitalizations for ambulatory care sensitive conditions (ACSC) among beneficiaries with and without intellectual and developmental disabilities (IDD) were examined using Medicaid and commercial claims from 2010–2014 in New Hampshire. IDD was defined with International Classification of Diseases, Ninth Edition, Clinical Modification (ICD-9-CM) codes using algorithms from the Centers for Medicare and Medicaid Services, and inpatient encounters were identified using the Healthcare Effectiveness Data and Information Set. In adjusted analyses, beneficiaries with IDD had more hospitalizations for ACSC than those without IDD in both insurance groups. Differences in patterns of ACSC prevalence, comorbidities, and hospital admissions between the commercially and Medicaid-insured groups show the value of using all-payer claims data, when possible, to understand health needs and health care utilization of insurance beneficiaries with IDD.


Neurology ◽  
2015 ◽  
Vol 86 (4) ◽  
pp. 367-374 ◽  
Author(s):  
John P. Ney ◽  
Barbara Johnson ◽  
Tom Knabel ◽  
Karolina Craft ◽  
Joel Kaufman

2018 ◽  
Vol 31 (7) ◽  
pp. 735-745
Author(s):  
Haichang Xin

Purpose The purpose of this paper is to examine whether high-cost-sharing ambulatory care policies affect non-urgent emergency department (ED) care utilization differently among individuals with and without chronic conditions. Design/methodology/approach This retrospective cohort study used 2010–2011 US Medical Expenditure Panel Survey data. Difference-in-difference methods, multivariate logit model and survey procedures were employed. Time lag effect was used to address endogeneity concerns. Findings The sample included 4,347 individuals. Difference in non-urgent ED visits log odds between high- and low-cost-sharing policies was not significantly different between chronically ill and non-chronically ill individuals (β=−0.48, p=0.42). Sensitivity analysis with 15 and 25 percent cost-sharing levels also generated consistent insignificant results (p=0.33 and p=0.31, respectively). Ambulatory care incidence rates were not significantly different between high- and low-cost-sharing groups among chronically ill people (incidence rate ratio=0.849, p=0.069). Practical implications High-cost-sharing ambulatory care policies were not associated with increased non-urgent ED care utilization among chronically ill and healthy people. The chronically ill patients may have retained sizable ambulatory care that was necessary to maintain their health. Health plans or employers may consider low-level cost-sharing policies for ambulatory care among chronically ill enrollees or employees. Originality/value Findings contribute to insurance benefit design; i.e., whether high-cost-sharing ambulatory care policies should be implemented among chronically ill enrollees to maintain their health and save costs for health plans.


2006 ◽  
Vol 6 (1) ◽  
Author(s):  
Tzeng-Ji Chen ◽  
Li-Fang Chou ◽  
Shinn-Jang Hwang

2016 ◽  
Vol 32 (5) ◽  
pp. 508-517
Author(s):  
Larry R. Hearld ◽  
Kristine R. Hearld ◽  
Claudia Guerrazzi

The patient-centered medical home (PCMH) has increasingly received attention as a model of care to potentially remedy the cost and quality problems that confront the US health care system, including and especially ambulatory care–related issues. This study examined the association between physician practices’ PCMH capacity and 3 indicators of ambulatory care utilization: (1) emergency department utilization, (2) ambulatory care sensitive hospitalization rate, and (3) 30-day all-cause readmission rate. Results show that overall PCMH capacity is associated with lower rates, and technical aspects of the PCMH in particular were associated with lower utilization rates while interpersonal capabilities were not.


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