Preventive Health Services for Medicare Beneficiaries: Randomized Control Trialof Alternative Methods of Screening and Provision of Preventive Services for Medicare Participants. (The Rural Health Promotion Project)

摘要

The demonstration provided preventive services to Medicare beneficiaries residingin rural counties in western Pennsylvania. 3,884 demonstration participants received health risk appraisals and were randomly assigned to two treatment groups and one control group. The treatment groups included beneficiaries receiving services at hospital-based and physician offices. The demonstration began offering preventive services in May 1989, and services ended in April 1991. The project did not decrease the extent of morbidity in the demonstration population. The project concluded that it is difficult to get people to use preventive services, particularly those services which require a significant amount of time and involvement on the part of the beneficiaries such as nutritional guidance and smoking cessation programs. In addition, it is extremely difficult to identify a capitation rate for preventive services in older adults because utilization rates are low. Furthermore, such programs are most likely to be used by people with more education.