Private Payers Serving Individuals with Disabilities and Chronic Conditions. APPENDIX B: Characteristics and Service Utilization By Plan Type

TABLE B-1a. Demographic, Employment, and Case Mix Characteristics of Disabled People Age 18-64, by Employer and Plan Type, 1995  
Measure Employer A Employer B
  Indemnity  
N=40676
POS
  N=29526  
Switched
  Plan Type  
N=3811
  Indemnity  
N=25060
PPO
  N=209  
HMO
  N=23135  
Switched
  Plan Type  
N=1794
Mean age 50.76 46.59 48.18* 48.32 48.55 42.60* 43.07
 
% Female 55.84 52.68* 54.19 56.08 53.59 57.82* 60.37*
% Male 44.16 47.32* 45.81 43.92 46.41 42.18* 39.63*
 
% of disabled who are employed 54.60 60.32* 58.36* 64.89 71.77 64.50 68.00*
% of disabled who are spouses 40.25 33.91* 36.63* 29.73 17.70* 30.31 26.98
% of disabled who are children or other dependents 5.15 5.77* 5.01 5.38 10.53* 5.19 5.02
* Significantly different from indemnity plan at p=0.05 level (Bonferroni t-test).

 

TABLE B-1b. Case Mix of Disabled People Age 18-64, by Employer and Plan Type, 1995
Measure Employer A Employer B
  Indemnity  
N=40676
POS
  N=29526  
Switched
  Plan Type  
N=3811
  Indemnity  
N=25060
PPO
  N=209  
HMO
  N=23135  
Switched
  Plan Type  
N=1794
Mean number of unique diagnoses on inpatient & outpatient claims submitted during the year 9.10 9.54* 8.46* 8.33 8.09 8.49* 9.07*
% of disabled persons who had complications identified on inpatient claims 0.98 1.05 0.71 0.56 0.00 0.65 0.33
Mean number of unique major diagnostic categories on inpatient & outpatient claims during the year 4.12 4.20 3.84 4.37 4.22 3.94* 4.65
% of disabled with a condition in:
MDC 1: Diseases and disorders of the nervous system 24.10 21.73* 18.60* 22.18 24.40 17.73* 20.29
MDC 2: Diseases and disorders of the eye 16.34 12.50* 12.67* 19.47 16.27 8.56* 15.27*
MDC 3: Diseases and disorders of the ear, nose, mouth, and throat 32.69 34.26* 34.48 33.92 38.76 33.24 42.14*
MDC 4: Diseases and disorders of the respiratory system 27.96 31.70* 24.72* 32.54 31.58 29.11* 31.61
MDC 5: Diseases and disorders of the circulatory system 44.54 43.67 38.57* 42.81 39.71 31.80* 35.12*
MDC 6: Diseases and disorders of the digestive system 25.47 25.78 25.19 27.12 19.14* 22.26* 26.98
MDC 7: Diseases and disorders of the hepatobiliary system and pancreas 4.03 4.14 3.73 5.11 2.39 3.98* 4.96
MDC 8: Diseases and disorders of the musculoskeletal system and connective tissue 45.90 48.62* 42.14* 50.61 48.33 41.44* 50.33
MDC 9: Diseases and disorders of the skin, subctaneous tissue, and breast 39.61 35.07* 35.24* 45.31 39.23 36.54* 42.47
MDC 10: Endocrine, nutritional and metabolic diseases and disorders 26.21 24.13* 24.38* 32.24 25.84 22.84* 29.26*
MDC 11: Diseases and disorders of the kidney and urinary tract 12.87 12.11* 11.76 15.08 13.88 11.48* 14.38
MDC 12: Diseases and disorders of the male reproductive system 6.83 6.47 5.69* 7.23 6.22 4.82* 5.46*
MDC 13: Diseases and disorders of the female reproductive system 17.85 14.99* 15.32* 21.26 11.96* 19.01* 24.69*
MDC 14: Pregnancy, childbirth, and the puerperium 1.35 2.68* 1.73 2.09 0.96 4.21* 3.29*
MDC 15: Newborns and other neonates with conditions originating in the perinatal period 0.41 0.53* 0.29 0.40 0.00 0.65* 0.78
MDC 16: Diseases and disorders of the blood, blood forming organs, and immunological disorders 6.31 6.56 5.30* 12.26 7.18 8.29* 11.98
MDC 17: Myeloproliferative diseases and disorders, poorly differentiated neoplasm 5.34 4.95 3.91* 3.77 3.35 3.25* 3.51
MDC 23: Factors influencing health status and other contacts with health services 45.50 58.73* 53.82* 23.73 56.94* 55.49* 53.01*
MDC 24: Multiple significant trauma 0.04 0.04 0.03 0.03 0.00 0.07 0.00
Mean number of unique Psychiatric Diagnostic Categories (PDGs) during the year 0.29 0.32* 0.24 0.34 0.23 0.38* 0.46*
% of disabled with a condition in:
PDG 1: Organic mental disorders 1.11 1.15 0.81 1.35 0.48 0.87* 0.95
PDG 2: Alcohol use disorders 1.18 1.54* 1.00 1.21 0.48 2.06* 1.67
PDG 3: Opioid and other substance use disorders 1.22 1.84* 1.29 0.86 1.44 2.33* 1.34*
PDG 4: Schizophrenia disorders 0.42 0.27* 0.21 0.37 0.00 0.26* 0.22
PDG 5: Other psychotic disorders (NEC) (NOS) 0.83 0.62* 0.50 0.69 0.48 0.67 0.61
PDG 6: Bipolar disorders 0.90 0.73* 0.87 1.00 0.48 0.82 1.00
PDG 7: Major depressions 4.85 5.25* 4.62 4.95 3.83 4.86 7.30*
PDG 8: Other specific and atypical affective disorders 2.76 2.97 2.34 4.27 3.83 3.48* 5.96
PDG 9: Post traumatic stress disorders 0.38 0.51* 0.26 0.91 0.00 0.85 1.23
PDG 10: Anxiety disorders 7.15 7.39 5.06* 6.25 3.83 7.67* 8.36*
PDG 11: Personality disorders 0.54 0.39* 0.13* 0.35 0.48 0.49* 0.45
PDG 12: Impulse control, adjustment disorders, and other mental disorders 7.26 8.84* 7.27* 8.18 6.22 10.06* 12.82*
% with adult activity-limiting condition 46.16 57.83* 35.71* 46.80 42.11 34.59* 34.56*
* Significantly different from indemnity plan at p=0.05 level (Bonferroni t-test).

 

TABLE B-1c. Utilization of Health Care Services Among People Age 18-64 with Disabilities, by Employer and Plan Type, 1995
Measure Employer A Employer B
  Indemnity  
N=40676
POS
  N=29526  
Switched
  Plan Type  
N=3811
  Indemnity  
N=25060
PPO
  N=209  
HMO
  N=23135  
Switched
  Plan Type  
N=1794
INPATIENT HOSPITAL CARE
% hospital during year 16.73 17.72* 12.91* 13.09 9.57 11.96* 10.20*
% hospitalized more than once during the year 4.50 4.74 2.99* 3.91 2.87 2.69* 3.51
% readmitted to hospital within 30 days of discharge from previous admission 2.03 2.00 1.21* 1.79 1.91 1.10* 1.62
Mean number of hospital admissions during the year, for hospital users 1.43 1.43 1.40 1.59 1.40 1.39* 1.72
% discharged dead, among total admissions (Employer A: Indemnity N=9743, POS N=7453, Switcher N=684, Employer B: Indemnity N=5188, PPO N=28, HMO N=3837, Switcher N=313) 2.19 1.05* 0.88* 1.04 3.57 1.20 0.96
% discharged to another facility, among total admissions 2.89 1.53* 2.19 2.24 7.14 2.79 4.79*
Mean LOSSCALE, among total admissions 117.36 110.49* 103.93* 113.96 138.93 106.90* 105.69
Mean RDSCALE, among total admissions 129.76 124.13 106.87* 113.62 147.93 111.37 99.89
Mean inpatient payments for the year, among inpatient (Employer A: Indemnity N=6804, POS N=5232, Switcher N=492, Employer B: Indemnity N=3281, PPO N=20, HMO N=2766, Switcher N=183) $18,031.21 $14,588.23* $14,930.62* $19,108.47 $32,418.10 $11,095.31* $14,184.83
Median outpatient expenditures during year $1,288.00 $1,303.00 $934.00 $1,600.00 $900.00 $859.00 $1,157.00
% using any therapies 6.52 21.65* 7.22 18.48 30.14* 17.26* 18.56
% using any home health care 8.66 8.38* 5.38* 4.27 8.13 7.69* 5.57
PRESCRIPTION DRUGS
Mean number of prescription drug claims in year among users 18.54 13.94* 12.20*        
Median number of prescription drug claims in year among users 13.00 9.00* 9.00*        
Mean drug expenditures during year among drug users 776.85 667.93* 683.54*        
Median drug expenditures during year among users 432.67 377.14- 389.68*        
* Significantly different from indemnity plan at p=0.05 level (Bonferroni t-test).

 

  TABLE B-2a. Demographic, Employment, and Case Mix Characteristics of Disabled People Under Age 18, by Employer and Plan Type, 1995  
  Measure   Employer A Employer B
  Indemnity  
N=5321
POS
  N=6730  
Switched
  Plan Type  
N=635
  Indemnity  
N=4036
PPO
  N=46  
HMO
  N=6796  
Switched
  Plan Type  
N=418
Mean age 10.04 9.57* 9.65 9.61 9.24 8.80* 8.95
 
% Female 41.05 40.46 39.84 43.81 43.48 41.91 43.30
% Male 58.95 59.54 60.16 56.19 56.52 58.09 56.70
* Significantly different from indemnity plan at p=0.05 level (Bonferroni t-test).

 

TABLE B-2b. Case Mix of Disabled People Under Age 18, by Employer and Plan Type, 1995
Measure Employer A Employer B
  Indemnity  
N=5321
POS
  N=6730  
Switched
  Plan Type  
N=635
  Indemnity  
N=4036
PPO
  N=46  
HMO
  N=6796  
Switched
  Plan Type  
N=418
Mean number of unique diagnoses on inpatient & outpatient claims submitted during the year 6.68 7.41* 6.68* 6.26 6.07 7.02* 7.23*
% of disabled persons who had complications identified on inpatient claims 0.41 0.24 0.16* 0.10 0.00 0.25 0.00
Mean number of unique major diagnostic categories on inpatient & outpatient claims during the year 3.28 3.74* 3.37 3.60 3.52 3.75* 4.03*
% of disabled with a condition in:
MDC 1: Diseases and disorders of the nervous system 16.73 12.72* 10.08* 16.23 17.39 11.30* 14.11
MDC 2: Diseases and disorders of the eye 10.92 10.24 11.50 12.93 4.35 9.73* 17.22*
MDC 3: Diseases and disorders of the ear, nose, mouth, and throat 64.41 64.78 67.56 66.67 58.70 63.68* 71.77
MDC 4: Diseases and disorders of the respiratory system 35.22 43.31* 34.65 41.11 28.26 39.61 40.19
MDC 5: Diseases and disorders of the circulatory system 8.18 7.83 8.19 7.83 13.04 6.33* 7.18
MDC 6: Diseases and disorders of the digestive system 14.64 15.54 14.02 16.03 10.87 14.96 17.46
MDC 7: Diseases and disorders of the hepatobiliary system and pancreas 1.18 1.22 0.47 1.26 0.00 1.19 1.44
MDC 8: Diseases and disorders of the musculoskeletal system and connective tissue 29.88 29.20 23.46* 33.08 28.26 26.72* 26.56*
MDC 9: Diseases and disorders of the skin, subctaneous tissue, and breast 32.96 31.81 31.18 35.78 32.61 34.03 34.45
MDC 10: Endocrine, nutritional and metabolic diseases and disorders 8.10 9.63* 5.35 12.56 17.39 11.09 7.42*
MDC 11: Diseases and disorders of the kidney and urinary tract 7.18 7.13 6.61 7.85 17.39 7.00 9.57
MDC 12: Diseases and disorders of the male reproductive system 1.45 1.47 1.26 1.44 2.17 1.94 1.91
MDC 13: Diseases and disorders of the female reproductive system 3.21 3.06 2.99 3.17 2.17 2.46 4.07
MDC 14: Pregnancy, childbirth, and the puerperium 0.71 0.80 0.31 0.22 0.00 0.50 0.48
MDC 15: Newborns and other neonates with conditions originating in the perinatal period 4.12 5.63* 2.99 5.13 10.87 4.87 3.35
MDC 16: Diseases and disorders of the blood, blood forming organs, and immunological disorders 4.77 4.78 4.88 7.23 10.87 6.52 8.85
MDC 17: Myeloproliferative diseases and disorders, poorly differentiated neoplasm 0.90 1.25 0.94 0.84 0.00 0.85 0.48
MDC 18: Infections and parasitic diseases, systemic or unspecified sites 14.38 16.15* 13.07 20.54 17.39 18.07* 24.40
MDC 19: Mental diseases and disorders 29.98 32.63* 28.03 26.49 15.22 23.69* 28.47
MDC 20: Alcohol/drug use and alcohol/drug induced organic mental disorders 1.15 1.29 0.79 0.87 0.00 1.06 1.20
MDC 21: Injuries, poisonings, and toxic effects of drugs 12.44 14.47* 13.23 15.71 13.04 15.66 16.27
MDC 22: Burns 0.62 0.55 0.31 0.47 0.00 0.74 0.96
MDC 23: Factors influencing health status and other contacts with health services 24.81 58.89* 54.59* 26.36 52.17* 72.57* 64.83*
MDC 24: Multiple significant trauma 0.06 0.07 0.16 0.00 0.00 0.07 0.00
Mean number of unique Psychiatric Diagnostic Categories (PDGs) during the year 0.41 0.42 0.36 0.31 0.20 0.30 0.36
% of disabled with a condition in:
PDG 1: Organic mental disorders 0.92 0.56 0.63 0.69 0.00 0.53 0.72
PDG 2: Alcohol use disorders 0.75 0.76 0.16 0.37 0.00 0.57 0.24
PDG 3: Opioid and other substance use disorders 1.22 1.23 0.94 0.52 0.00 0.97 0.96
PDG 4: Schizophrenia disorders 0.11 0.03 0.00 0.05 0.00 0.04 0.00
PDG 5: Other psychotic disorders (NEC) (NOS) 0.92 0.73 1.10 0.67 0.00 0.53 1.20
PDG 6: Bipolar disorders 0.73 0.40* 0.79 0.50 0.00 0.19 0.24
PDG 7: Major depressions 3.63 4.06 2.36 2.16 2.17 1.75 2.39
PDG 8: Other specific and atypical affective disorders 2.57 2.01 3.31 2.30 0.00 1.72 3.11
PDG 9: Post traumatic stress disorders 0.71 0.76 0.00 0.37 0.00 0.72* 0.96
PDG 10: Anxiety disorders 4.40 3.25* 1.73* 2.85 6.52 2.78 1.20
PDG 11: Personality disorders 0.21 0.27 0.00 0.20 0.00 0.19 0.00
PDG 12: Impulse control, adjustment disorders, and other mental disorders 24.86 27.83* 25.04 19.40 10.87 18.81 22.01
% with adult activity-limiting condition 38.43 51.43* 29.13* 44.47 34.78 41.29* 39.23
* Significantly different from indemnity plan at p=0.05 level (Bonferroni t-test).

 

TABLE B-2c. Utilization of Health Care Services Among People Under Age 18 with Disabilities, by Employer and Plan Type, 1995
Measure Employer A Employer B
  Indemnity  
N=5321
POS
  N=6730  
Switched
  Plan Type  
N=635
  Indemnity  
N=4036
PPO
  N=46  
HMO
  N=6796  
Switched
  Plan Type  
N=418
INPATIENT HOSPITAL CARE
% hospital during year 10.64 11.58 7.56 9.24 13.04 7.28 5.74
% hospitalized more than once during the year 2.42 2.41 2.20 1.96 4.35 1.47 1.20
% readmitted to hospital within 30 days of discharge from previous admission 1.20 1.07 0.63 0.42 0.00 0.68 0.24
Mean number of hospital admissions during the year, for hospital users (Employer A: Indemnity N=566, POS N=779, Switcher N=48, Employer B: Indemnity N=373, PPO N=6, HMO N=495, Switcher N=24) 1.41 1.36 1.31 1.33 1.50 1.38 1.50
% discharged dead, among total admissions (Employer A: Indemnity N=796, POS N=1055, Switcher N=63, Employer B: Indemnity N=496, PPO N=9, HMO N=672, Switcher N=36) 0.00 0.38 1.59 0.00 0.00 0.30 0.00
% discharged to another facility, among total admissions (Employer A: Indemnity N=796, POS N=1055, Switcher N=63, Employer B: Indemnity N=496, PPO N=9, HMO N=672, Switcher N=36) 1.76 1.04 0.00 0.20 11.11* 0.74 0.00
Mean LOSCALE, among total admissions (Employer A: Indemnity N=796, POS N=1055, Switcher N=63, Employer B: Indemnity N=496, PPO N=9, HMO N=672, Switcher N=36) 136.64 143.32 192.86 132.35 108.00 137.24 124.44*
Mean RDSCALE, among total admissions (Employer A: Indemnity N=796, POS N=1055, Switcher N=63, Employer B: Indemnity N=496, PPO N=9, HMO N=672, Switcher N=36) 102.34 102.22 112.62 94.37 79.00 125.56 65.00
Mean inpatient payments for the year, among inpatient users (Employer A: Indemnity N=566, POS N=779, Switcher N=48, Employer B: Indemnity N=373, PPO N=6, HMO N=495, Switcher N=24) $14,447.90 $13,472.62 $18,203.75 $11,649.93 $9,386.50 $16,435.92 $6,346.42
Median inpatient payments for the year, among inpatient users (Employer A: Indemnity N=566, POS N=779, Switcher N=48, Employer B: Indemnity N=373, PPO N=6, HMO N=495, Switcher N=24) $5,031.50 $4,460.00 $5,911.50 $4,315.00 $7,075.50 $4,436.00 $4,015.00
OUTPATIENT CARE
Mean number of outpatient claims during year 19.41 23.79* 19.17 21.03 15.24 22.05 21.57
Mean number of outpatient claim-days during year 11.14 11.84* 10.02 10.94 6.91* 10.07* 11.20
Mean outpatient expenditures during year $1,759.05 $1,486.92* $1,446.13 $1,695.74 $909.89 $1,132.06 $1,344.20
Median outpatient expenditures during year %645.00 $649.00 $529.00 $774.50 $549.50 $586.00 $707.50
% using any therapies 8.25 11.63* 5.83 10.68 6.52 7.53* 5.98*
% using any home health care 6.37 8.08* 4.72 4.31 6.52 10.33* 6.46
PRESCRIPTION DRUGS
Mean number of prescription drug claims in year among users 8.31 5.73* 5.55*        
Median number of prescription drug claims in year among users 6.00 4.00* 3.00*        
Mean drug expenditures during year among drug users $270.42 $233.53 $298.96        
Median drug expenditures during year among users $104.60 $95.38* $81.15        
* Significantly different from indemnity plan at p=0.05 level (Bonferroni t-test).

 

  TABLE B-3a. Demographic, Employment, and Case Mix Characteristics of Disabled Early Retirees, by Employer and Plan Type, 1995  
  Measure   Employer A Employer B
  Indemnity  
N=6621
POS
  N=3390  
Switched
  Plan Type  
N=510
  Indemnity  
N=2859
PPO
  N=62  
HMO
  N=822  
Switched
  Plan Type  
N=73
Mean age 60.28 59.04* 59.80 58.79 62.94* 58.70 56.25*
               
% Female 27.99 27.14 29.22 37.29 38.71 42.58* 49.32
% Male 72.01 72.86 70.78 62.71 61.29 57.42 50.68
* Significantly different from indemnity plan at p=0.05 level (Bonferroni t-test).

 

TABLE B-3b. Case Mix of Disabled Early Retirees, by Employer and Plan Type, 1995
Measure Employer A Employer B
  Indemnity  
N=6621
POS
  N=3390  
Switched
  Plan Type  
N=510
  Indemnity  
N=2859
PPO
  N=62  
HMO
  N=822  
Switched
  Plan Type  
N=73
Mean number of unique diagnoses on inpatient & outpatient claims submitted during the year 9.85 10.77* 90.5* 9.68 10.16 10.37* 9.84
% of disabled persons who had complications identified on inpatient claims 1.19 1.30 0.78 0.66 0.00 1.09 0.00
Mean number of unique major diagnostic categories on inpatient & outpatient claims during the year 4.32 4.47* 3.87* 4.83 4.65 4.58 4.82
% of disabled with a condition in:
MDC 1: Diseases and disorders of the nervous system 24.88 21.86* 18.43* 25.18 16.13 21.05 24.66
MDC 2: Diseases and disorders of the eye 22.53 18.41* 17.06* 28.26 32.26 16.30* 21.92
MDC 3: Diseases and disorders of the ear, nose, mouth, and throat 27.87 28.11 26.67 29.45 35.48 25.06 45.21*
MDC 4: Diseases and disorders of the respiratory system 30.95 34.34* 25.49* 36.76 38.71 32.97 34.25
MDC 5: Diseases and disorders of the circulatory system 62.57 65.46* 56.86* 64.85 61.29 58.03* 65.75
MDC 6: Diseases and disorders of the digestive system 28.61 29.59 26.27 31.69 20.97 27.98 39.73
MDC 7: Diseases and disorders of the hepatobiliary system and pancreas 4.91 4.84 4.51 6.51 1.61 4.87 2.74
MDC 8: Diseases and disorders of the musculoskeletal system and connective tissue 42.94 45.07 41.18 50.75 48.39 44.53* 47.95
MDC 9: Diseases and disorders of the skin, subctaneous tissue, and breast 35.83 34.04 31.76 47.18 33.87 41.61* 41.10
MDC 10: Endocrine, nutritional and metabolic diseases and disorders 33.20 34.93 34.51 44.67 40.32 41.61 32.88
MDC 11: Diseases and disorders of the kidney and urinary tract 13.90 13.07 12.16 17.91 14.52 15.69 12.33
MDC 12: Diseases and disorders of the male reproductive system 16.37 17.40 14.31 15.88 12.90 13.26 10.96
MDC 13: Diseases and disorders of the female reproductive system 7.60 5.10* 4.71* 11.79 3.23 7.66* 12.33
MDC 14: Pregnancy, childbirth, and the puerperium 0.17 0.29 0.00 0.24 0.00 0.12 0.00
MDC 15: Newborns and other neonates with conditions originating in the perinatal period 0.29 0.24 0.20 0.35 0.00 0.61 0.00
MDC 16: Diseases and disorders of the blood, blood forming organs, and immunological disorders 7.69 7.96 5.69 15.36 11.29 12.77 9.59
MDC 17: Myeloproliferative diseases and disorders, poorly differentiated neoplasm 7.16 7.08 3.53* 4.93 4.84 6.57 4.11
MDC 18: Infections and parasitic diseases, systemic or unspecified sites 3.66 3.07 2.16 5.67 4.84 6.57 4.11
MDC 19: Mental diseases and disorders 10.81 10.18 7.65 16.51 8.06 14.96 16.44
MDC 20: Alcohol/drug use and alcohol/drug induced organic mental disorders 0.66 1.00 0.20 1.50 0.00 1.58 2.74
MDC 21: Injuries, poisonings, and toxic effects of drugs 6.33 7.88* 5.49 9.16 4.84 8.64 12.33
MDC 22: Burns 0.20 0.15 0.20 0.24 1.61 0.36 0.00
MDC 23: Factors influencing health status and other contacts with health services 43.04 57.32* 48.24 17.80 69.35* 56.20* 42.47*
MDC 24: Multiple significant trauma 0.03 0.06 0.00 0.00 0.00 0.12 0.00
Mean number of unique Psychiatric Diagnostic Categories (PDGs) during the year 0.19 0.20 0.12* 0.26 0.13 0.27 0.27
% of disabled with a condition in:
PDG 1: Organic mental disorders 1.28 1.45 1.18 2.27 0.00 1.34 0.00
PDG 2: Alcohol use disorders 0.83 1.30 0.20 1.12 0.00 1.82 2.74
PDG 3: Opioid and other substance use disorders 0.85 1.50* 0.00 0.56 0.00 2.19* 1.37
PDG 4: Schizophrenia disorders 0.50 0.32 0.59 0.59 0.00 0.36 0.00
PDG 5: Other psychotic disorders (NEC) (NOS) 0.86 0.50 0.98 1.33 0.00 0.73 0.00
PDG 6: Bipolar disorders 0.59 0.53 0.59 1.36 0.00 1.22 1.37
PDG 7: Major depressions 2.79 3.24 2.16 5.35 3.23 3.89 5.48
PDG 8: Other specific and atypical affective disorders 1.51 1.42 0.59 2.80 3.23 2.19 5.48
PDG 9: Post traumatic stress disorders 0.14 0.12 0.00 0.42 0.00 0.49 0.00
PDG 10: Anxiety disorders 4.55 3.54* 1.76* 3.92 4.84 5.60 5.48
PDG 11: Personality disorders 0.36 0.24 0.20 0.38 0.00 0.24 0.00
PDG 12: Impulse control, adjustment disorders, and other mental disorders 4.47 5.66* 3.73 6.05 1.61 7.06 5.48
% with childhood activity-limiting condition 62.00 74.22* 53.53* 64.32 53.23 53.65* 47.95*
* Significantly different from indemnity plan at p=0.05 level (Bonferroni t-test).

 

TABLE B-3c. Utilization of Health Care Services Among Early Retirees with Disabilities, by Employer and Plan Type, 1995
Measure Employer A Employer B
  Indemnity  
N=6621
POS
  N=3390  
Switched
  Plan Type  
N=510
  Indemnity  
N=2859
PPO
  N=62  
HMO
  N=822  
Switched
  Plan Type  
N=73
INPATIENT HOSPITAL CARE
% hospital during year 20.80 22.36 15.69* 18.33 9.68 18.13 8.22
% hospitalized more than once during the year 6.33 6.67 2.55* 6.02 4.84 6.33 4.11
% readmitted to hospital within 30 days of discharge from previous admission 2.98 2.83 0.98* 3.25 3.23 3.41 1.37
Mean number of hospital admissions during the year, for hospital users (Employer A: Indemnity N=1377, POS N=758, Switcher N=80; Employer B: Indemnity N=524, PPO N=6, HMO N=149, Switcher N=6) 1.48 1.47 1.18* 1.70 1.67 1.75 1.83
% discharged dead, among total admissions 3.06 1.62* 1.06 1.59 10.00 1.92 0.00
% discharged to another facility, among total admissions 3.70 1.89* 1.06 3.64 10.00 2.30 18.18
Mean LOSCALE, among total admissions (Employer A: Indemnity N=2026, POS N=1110, Switcher N=94, Employer B: Indemnity N=880, PPO N=10, HMO N=261, Switcher N=11) 118.48 119.16 106.96 114.68 183.50* 128.45 98.45
Mean RDSCALE, among total admissions 144.59 152.82 122.16 123.27 235.10 144.06 92.45
Mean inpatient payments for the year, among inpatient users $20,650.33 $17,502.53 $13,245.58 $22,633.04 $88,107.00 $17,657.91 $12,812.17
Median inpatient payments for the year, among inpatient users $11,536.00 $9,681.50* $6,428.50* $12,667.50 $18,585.50 $8,869.00* $10,874.00
OUTPATIENT CARE
Mean number of outpatient claims during year 33.38 46.81* 33.69 41.75 36.32 41.94 37.62
Mean number of outpatient claim-days during year 14.81 18.18* 13.91 17.11 16.68 15.47 15.88
Mean outpatient expenditures during year $3,568.53 $3,365.35 $2,870.81 $4,798.66 $2,846.56 $2,798.60* $2,987.36
Median outpatient expenditures during year $1,494.50 $1,601.00* $1,064.00* $2,268.00 $1,036.00* $1,177.00* $1,573.00*
% using any therapies 4.95 12.95* 7.25 15.42 25.81 12.41 12.33
% using any home health care 10.8 11.86* 8.24 5.96 12.50 11.83* 12.23*
PRESCRIPTION DRUGS
Mean number of prescription drug claims in year among users 22.16 17.73* 14.70*        
Median number of prescription drug claims in year among users 16.00 12.00* 11.00*        
Mean drug expenditures during year among drug users $936.70 $858.51* $803.97*        
Median drug expenditures during year among users $594.36 $552.90* $531.84*        
* Significantly different from indemnity plan at p=0.05 level (Bonferroni t-test).

 

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