Abstract
Because people aged sixty-five or older have more illnesses, injuries, disabilities, and restricted activities than the younger population, they use health care services at a higher rate and incur greater health care expenses. Health maintenance organizations (HMOs) and organized medical group practices have been identified as being capable of providing cost effective health care for relatively large volumes of people sixty-five years of age or older. These organizations must be able to select and maintain sufficient medical manpower in medical specialties to provide the care needed. The inability to predict medical manpower needs with precision seriously hampers health care delivery to the elderly. This problem is addressed in this study of primary care physician resource utilization by the elderly in an ambulatory care setting. A sample population of 32,377 patients age fifty-five or older was selected. The target age fifty-five allows the researcher to examine the resources used by patients over ten years as they progressed in age. The medical records (archival data source) of the sample population were selected for data abstraction. Inferential statistical models were used to make judgements about these data, and to generalize these judgements to the total population, in response to the following research questions: (1) Are there significant differences in the physician resource utilization of patients in a health maintenance organization, beginning at age fifty-five, and the number of years the patient receives care in the organization? (2) What relationship exists between the number of physician visits and the age progression of elderly patients beginning at age fifty-five? (3) Is there a relationship between the number of ambulatory care visits and the number of hospitalizations for patients age fifty-five or older? (4) Is there any relationship between the medical problems of hospitalized patients and the problems managed in the ambulatory care settings? (5) Will the answers to these research questions provide sufficient data to create a model for assigning physician resources to care for elderly patients in health maintenance organizations? Statistically valid planning models demonstrate that as the population increases in age, the number of years in the organization, and number of hospital admissions, the primary care physician requirements will increase. The results of this study contribute to the knowledge required for comprehensive health planning for the rapidly growing elderly population. (Abstract shortened with permission of author.).