Effects of Medicare on Hospital Use: A Disease-Specific Study

Ferguson, Christine; Ml, Lee; Wallace, Ryan M.

doi:10.1097/00005650-197607000-00003

Cited by 8 publications

(1 citation statement)

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“…15 (Subsequently, as hospital supply increased, overall hospital utilization rose. 15,59,60 ) However, hospital care was redistributed, rising among seniors 15,59,[61][62][63] and those with low incomes, 15 and falling among the non-elderly 15,61,62 and higher-income groups. 15 According to both household and physician surveys, society-wide physician utilization-measured by both visits and surgical procedures-also remained flat following the expansion, 14,[64][65][66] although, like hospital care, it was redistributed.…”

Section: Utilization Trendsmentioning

confidence: 99%

The Effect of Large-scale Health Coverage Expansions in Wealthy Nations on Society-Wide Healthcare Utilization

2019

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Most analysts project that a reform like Medicare-for-All that lowers financial barriers to care would cause a surge in the utilization of services, raising costs despite stable or even reduced prices. However, the finite supply of physicians and hospital beds could constrain such utilization increases. We reviewed the effects of 13 universal coverage expansions in capitalist nations on physician and hospital utilization, beginning with New Zealand's 1938 Social Security Act up through the 2010 Affordable Care Act in the USA. Almost all coverage expansions had either a small (i.e., < 10%) or no effect on society-wide utilization. However, coverage expansions often redistributed care-increasing use among newly covered groups while producing small, offsetting reductions among those already covered. We conclude that in wealthy nations, large-scale coverage expansions need not cause overall utilization to surge if provider supply is controlled. However, such reforms could redirect care towards patients who most need it.

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Section: Utilization Trendsmentioning

confidence: 99%

The Effect of Large-scale Health Coverage Expansions in Wealthy Nations on Society-Wide Healthcare Utilization

2019

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Socioeconomic Factors Affecting the Utilization of Surgical Operations

et al. 1977

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Between 1963 and 1970 public programs were introduced to reduce inequalities in access to medical care. We examined differentials in surgical utilization among socioeconomic groups in 1970 as well as changes between 1963 and 1970. Multivariate analysis of National Health Interview Survey data indicated that large increases in surgical utilization occurred among disadvantaged groups: the aged, lower educated and nonwhites in urban areas. Some differential by race and residence remains, but is strongly related to income. Income had a large positive effect on surgical utilization, but this effect was less strong in 1970 than in 1963. Education had a negative effect on surgical utilization. Eleven surgical procedures were selected and scaled on indexes of "complexity," "urgency" and "necessity." These indexes do not vary among demographic groups that have significant differences in surgical utilization. However, lower-income groups utilized to a lesser extent procedures rated lowest on the necessity scale.

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