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PubMedDate not supplied

Use of health care services following mandatory retirement.

I examined the use of health care services before and after mandatory retirement. Data were collected from provincial medical care and hospital insurance records for each of 88 retirees. Interview data provided information about selected psychosocial and health factors which earlier studies found to be related to health status. Two patterns in use of health care services were found: in one group (N = 54), use of health care services increased and in the other group (N = 34), use of services decreased following mandatory retirement. Discriminant analysis procedures were applied to determine which factors could predict group membership. Two factors were found to be important for correct identification of group membership: part-time employment and including all food groups in the diet on the day before the interview. Based on this combination of factors, group membership could be correctly identified 55% of the time for the increased usage group, and 82% of the time for the decreased usage group.

Aged↗
PubMed1989

The triple option choice: self-selection bias in traditional coverage, HMOs, and PPOs.

Health care costs and utilization by salaried employees and their dependents at a large self-insured midwestern industrial manufacturing corporation were analyzed for the year before employees were first offered a triple option choice. Members had the option of retaining traditional Blue Cross and Blue Shield of Michigan (BCBSM) coverage or switching to either a number of health maintenance organizations (HMOs) or a number of preferred provider organizations (PPOs). Members who switched to HMOs or PPOs were generally younger and had lower average expenses and utilization rates than those who retained the traditional BCBSM plan. The results suggest that a selection bias does occur in this population, as lower cost members were more attracted to the HMOs and PPOs than were more expensive members. Implications for the corporation as well as for the drive toward managed care alternatives are discussed.

Age Factors↗
PubMed1989

Intraoperative controls for bacterial contamination during total knee replacement.

The increasing number of infected total knee replacements produces a financial and social burden upon patients, families, hospitals, insurance companies, and government. Methods of reducing the problem of wound infection are discussed in this article, including prophylactic anticoagulation, CPM, autologous blood replacement, good nutrition, and careful wound closure.

Bacteria↗
PubMed1986

Will quitting smoking help Medicare solve its financial problems?

Although health promotion programs may increase the quality and length of life and worker productivity, they will increase the demands on Medicare's hospital insurance (HI) fund when those who benefit from such programs become eligible for Medicare. In this study, I develop and apply a procedure for estimating the net effect of quitting smoking on the HI fund. As the mortality rates of quitters begin to approach those for "neversmokers," contributions to the HI fund increase. The fund experiences a net decrease when these "additional quitters alive" begin to receive Medicare benefits. I found that the net effect of each male light smoker who quits at age 45 increases the present value (in 1980 dollars) of the HI fund's net expenses by between $204 and $2,745, depending on the discount and interest factors used.

Adult↗
PubMed1988

Medicare Catastrophic Coverage Act of 1988.

The Medicare Catastrophic Coverage Act of 1988 is described, and implications for pharmacy are discussed. The Catastrophic Coverage Act, which will be phased in between 1989 and 1993, provides for the following benefits for Medicare beneficiaries: Under Part A, a single annual deductible and an unlimited number of days for inpatient care and covered services and improved benefits for hospice and skilled-nursing-care facilities; under Part B, a limit on out-of-pocket expenses, improved home-care benefits (including home i.v. therapy), and an outpatient prescription benefit. Long-term care was not addressed in this legislation; benefits for extended-care services were expanded, but they apply only to an acute illness. The new benefit for outpatient prescriptions provides for payment for both the drug product and professional services by the pharmacy. The benefits will be financed through a supplemental premium to be paid by all individuals who are eligible for Part A. The pharmacy profession should work with the Department of Health and Human Services in implementing the Act to ensure that this opportunity results in improved patient care through the wise application of pharmaceutical services.

Catastrophic Illness↗