Although the prevalence of patients enrolled in managed care increased throughout the study, the process was gradual. The hospital already used a system of diagnosis related groups prior to the intervention. No capitation arrangements had been established with practicing physicians. Interestingly, children who had private insurance and Medicaid as primary payers experienced similar decreases in discharges and lengths of stay during the study period, arguing against a significant effect due to managed care. Finally, no new programs like nursing facilities were established during the study period.
Every medical center is unique.
We therefore hope that other programs will try to replicate our findings with children who have special health care needs. All rights reserved.