New insurees no extra drain
Contrary to what the health care industry may have predicted, a study shows that previously uninsured patients who are given access to managed care use medical facilities at the same rate as longer-term enrollees.
Harvey Bograd, MD, and other researchers at Kaiser Permanente of Colorado in Denver, compared 346 previously uninsured low-income patients with 382 control patients over a two-year period. Some participants in a program were offered reduced rates for health insurance and received subsidized discounted dues.
"There were no significant differences between the previously uninsured study and the control group in use of services that are of particular financial concern: hospital admissions, hospital days, and use of outpatient laboratory, pharmacy, and radiology services," the authors write in the April 2 issue of the Journal of the American Medical Association (1997; 277:1,067-1,072). "While the study group had 51% more specialty visits per enrollee, the distribution of visits by type of specialty was similar."
Adults in the study group reported significantly lower self-perceived health status and a higher rate of tobacco use and history of diabetes. Children in the study group spent more days in bed or missing school than the control group.
One result that surprised researchers was the similarities in start-up use levels for the two groups. Bograd explained that researchers had expected excessive use at first due to a pent-up need for medical care.
The article concludes that providing access to health care for the uninsured can be accomplished at moderately economical rates. "A program like the one studied here can serve as a viable model for this work," the researchers write.
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