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. 1979 Summer;1(1):79-107.

Analysis of variations in hospital use by Medicare patients in PSRO areas, 1974-1977

R Deacon, J Lubitz, M Gurnick, M Newton

Analysis of variations in hospital use by Medicare patients in PSRO areas, 1974-1977

R Deacon et al. Health Care Financ Rev. 1979 Summer.

Abstract

A study of the use of short-stay hospitals in PSRO areas by Medicare enrollees aged 65 and over for the period 1974 through 1977 revealed that discharge rates increased, average length of stay (ALOS) decreased, and days-of-care rates remained relatively constant in nearly all of the PSRO areas. The data show large variations in hospital use in PSRO areas within States and HEW regions, and suggest that factors within the area are critical determinants of hospital utilization. This study presents important implications for PSRO program policy for it suggests that factors other than physician and hospital behavior should also be considered when setting objectives for reducing misutilization and improving the quality of health care.

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Figures

Figure 1
Figure 1. U.S. Discharge rates, ALOS, and days-of-care rates for beneficiaries aged 65 and over, 1967-77
Figure 2
Figure 2. HEW Regional Boundaries
Figure 3
Figure 3. Percent Distributions of PSRO Areas by Change in Discharge Rates, Average Length of Stay, and Days-of-Care Rates, for Medicare Beneficiaries, aged 65 and over, 1974-77
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References

    1. Tables similar to those presented in this report by PSRO area have been developed by health service area and will be made available to all Health Systems Agencies.

    1. The “Health Planning and Resources Development Act of 1974” authorized the creation of Health Systems Agencies (HSAs) in about 200 Health Service Areas Nation-wide to carryout various health planning functions in their areas.

    1. Bailey Norman TJ. Statistics in Hospital Planning and Design. Applied Statistics. 1965 Nov;:146–157.

    1. The data presented in this article were also used as the basic data set in the 1978 PSRO evaluation study. It is important to note that in the PSRO evaluation study, regression analysis techniques were used to focus on changes in utilization from 1974 to 1977, after adjusting for variables (e.g., hospital bed supply) which might affect PSRO impact. Consequently, actual changes in use rates shown in table 1 will differ from the regression result of the PSRO evaluation study. These differences are also discussed on page 67 of the 1978 PSRO evaluation study (HEW Pub. No. HCFA-03000, Jan. 1979).

    1. Only PSRO areas in the 50 States were considered.

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