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  1. Fulltext. Effects of health care cost-containment programs on patterns of care and readmissions among children and adolescents.

    Article - En anglais

    Fulltext.

    Objectives

    This study examined the effects of a utilization management program on patterns of medical care among children and adolescents.

    Methods

    From 1989 through 1993, the program conducted 8568 reviews of pediatric patients, ranging in age from birth to 18 years.

    The program used preadmission and concurrent review procedures to review and certify patients'need for care.

    This study used multivariate analyses to assess changes in the number of days of impatient care approved by the program and to determine whether limitations imposed on length of stay affected the risk of 60-day readmission.

    Results

    Concurrent review reduced the number of requested days of inpatient care by 3.2 days per patient.

    Low-birthweight infants and adolescent patients with depression or alcohol or drug dependence accounted for a disproportionate share of the reduction.

    Patients classified as admitted for medical or mental health care and whose stay was restricted by concurrent review were more likely (P<. 05) to be readmitted within 60 days after discharge.

    Conclusions

    By limiting care through its review procedures, the utilization management program decreased inpatient resource consumption but also increased the risk of readmission for some patients.

    Continued investigation should be conducted of the effects of cost-containment programs on the quality of care given to children and adolescents, especially in the area of mental health.

    Mots-clés Pascal : Enfant, Homme, Adolescent, Soin intégré, Soin, Analyse coût, Economie santé, Etats Unis, Amérique du Nord, Amérique, Utilisation, Contrôle coût, Adéquation

    Mots-clés Pascal anglais : Child, Human, Adolescent, Managed care, Care, Cost analysis, Health economy, United States, North America, America, Use, Cost control

    Logo du centre Notice produite par :
    Inist-CNRS - Institut de l'Information Scientifique et Technique

    Cote : 99-0517251

    Code Inist : 002B30A04B. Création : 18/05/2000.