Hospital Utilization and Expenditures in a Medicaid Population

By Buczko, William | Health Care Financing Review, Fall 1989 | Go to article overview

Hospital Utilization and Expenditures in a Medicaid Population


Buczko, William, Health Care Financing Review


Hospital utilization and expenditures in a Medicaid population

Introduction

There have been many studies of hospital utilization and expenditures for the general population but few studies of hospital utilization and expenditures for Medicaid enrollees. Rarely, in studies for either the general or the Medicaid population, are individual-level demographic, attitudinal, health status, diagnostic, source-of-payment, and expenditure data linked to permit multivariate analysis of hospital utilization and expenditures.

In this article, regression analysis is used to examine the determinants of the probability of a hospital visit, the number of hospitalizations, and the total inpatient hospital expenditures for Medicaid enrollees in the States of California, Michigan, New York, and Texas who were continuously enrolled throughout 1980. The data source for this study, the State Medicaid household sample portion of the National Medical Care Utilization and Expenditure Survey, is one of the few data bases containing representative samples of Medicaid enrollees in different States and self-reports of utilization and expenditures validated with Medicaid claims data.

The abundance of demographic, health status, income, source-of-payment, and employment information accompanying the data on medical care expenditures and utilization presents the opportunity for a detailed cross-sectional evaluation of the determinants of utilization and expenditures for Medicaid enrollees across four State Medicaid populations. These results can be compared with findings obtained for the general population (e.g., Mauskopf, Rodgers, and Dobson, 1985) as well as for State Medicaid populations (e.g., Kasper, 1986).

Recently, several comparative studies of State Medicaid populations have been based on data from the Tape-to-Tape project, which includes enrollment, claims, and provider data from the Medicaid Management Information Systems of five States: California, Georgia, Michigan, New York, and Tennessee. Hospital utilization and expenditures by condition (Pine, Howell, and Buczko, 1987); long-term care (McMillan et al., 1987; Ray et al., 1987; Burwell et al., 1987); and health care for children covered by Medicaid (Rymer and Adler, 1987) have been examined in these studies. In other studies, aggregate data from Form 2082 submitted to the Health Care Financing Administration have been used to determine the impact of State Medicaid program characteristics on reimbursement, number of recipients, and State program expenditures (McDevitt and Buczko, 1985; Zuckerman, 1987).

Hospital utilization and

expenditure studies

Inpatient utilization of hospitals varies across sex and age groups. In the 1980 National Hospital Discharge Survey, it was found that females had more hospitalizations and shorter lengths of stay than males had (Haupt, 1982). If hospitalizations for deliveries are not considered, hospitalization rates, length of stay, and prevalence of diagnoses were nearly equal for both sexes.

Persons 65 years of age or over are more likely to be hospitalized and have longer stay lengths and higher hospital expenses than younger persons, regardless of sex. Cromwell et al. (1982) found that aged and disabled Supplemental Security Income enrollees had the highest rates of hospitalization and lengths of stay among Medicaid enrollees in Tennessee.

According to the 1980 National Hospital Discharge Survey data (Haupt, 1982), diseases of the circulatory system were a major cause of hospitalization for all adult age groups and were especially prevalent among those 65 years of age or over, accounting for 29 percent of hospitalizations for persons in this age group. Diseases of the digestive system, malignant tumors, and respiratory diseases were also more prevalent as age increased (McCarthy, 1983; Haupt, 1982; Garnick and Short, 1985) and were often associated with the most expensive hospitalizations among the elderly (Hodgson and Kopstein, 1984). …

The rest of this article is only available to active members of Questia

Sign up now for a free, 1-day trial and receive full access to:

  • Questia's entire collection
  • Automatic bibliography creation
  • More helpful research tools like notes, citations, and highlights
  • A full archive of books and articles related to this one
  • Ad-free environment

Already a member? Log in now.

Notes for this article

Add a new note
If you are trying to select text to create highlights or citations, remember that you must now click or tap on the first word, and then click or tap on the last word.
One moment ...
Default project is now your active project.
Project items

Items saved from this article

This article has been saved
Highlights (0)
Some of your highlights are legacy items.

Highlights saved before July 30, 2012 will not be displayed on their respective source pages.

You can easily re-create the highlights by opening the book page or article, selecting the text, and clicking “Highlight.”

Citations (0)
Some of your citations are legacy items.

Any citation created before July 30, 2012 will labeled as a “Cited page.” New citations will be saved as cited passages, pages or articles.

We also added the ability to view new citations from your projects or the book or article where you created them.

Notes (0)
Bookmarks (0)

You have no saved items from this article

Project items include:
  • Saved book/article
  • Highlights
  • Quotes/citations
  • Notes
  • Bookmarks
Notes
Cite this article

Cited article

Style
Citations are available only to our active members.
Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

(Einhorn, 1992, p. 25)

(Einhorn 25)

1

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Cited article

Hospital Utilization and Expenditures in a Medicaid Population
Settings

Settings

Typeface
Text size Smaller Larger Reset View mode
Search within

Search within this article

Look up

Look up a word

  • Dictionary
  • Thesaurus
Please submit a word or phrase above.
Print this page

Print this page

Why can't I print more than one page at a time?

Help
Full screen

matching results for page

    Questia reader help

    How to highlight and cite specific passages

    1. Click or tap the first word you want to select.
    2. Click or tap the last word you want to select, and you’ll see everything in between get selected.
    3. You’ll then get a menu of options like creating a highlight or a citation from that passage of text.

    OK, got it!

    Cited passage

    Style
    Citations are available only to our active members.
    Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn, 1992, p. 25).

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn 25)

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences."1

    1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

    Cited passage

    Thanks for trying Questia!

    Please continue trying out our research tools, but please note, full functionality is available only to our active members.

    Your work will be lost once you leave this Web page.

    For full access in an ad-free environment, sign up now for a FREE, 1-day trial.

    Already a member? Log in now.