Study reveals new drugs, patient education changing managed care, hospitals

New drugs, the increasing use of drug therapies and the emergence of consumer healthcare education have profoundly affected healthcare delivery, according to "Managed Care Trends 2000," a 15-year study of healthcare industry benchmarks sponsored by Aventis Pharmaceuticals Inc., Bridgewater, NJ.

The surge in the use of prescription drugs has been accompanied by declining hospital admission rates and shorter lengths-of-stay, according to the study.

The study found that:

•Â The average number of prescriptions per commercial healthcare maintenance organization member per year increased 43% between 1988 and 1998.

•Â Hospital admissions per 1,000 commercial HMO members fell 22% between 1990 and 1998.

•Â The number of days spent in the hospital per 1,000 members declined 46% during the same time period.

Factors driving the surge in the use of pharmaceuticals include the introduction of new drugs, new uses for existing drugs and an increased emphasis on patient education, said John Rodgers, director of pharmacy at Independent Health Association, a 400,000-member HMO in Buffalo, NY.

"We've discovered new drugs and new applications for existing drugs, all to the benefit of the patient," Rodgers said. "We're prescribing more drugs because they happen to be the best therapy for any number of conditions."

Other advances

In addition to new drugs, advances in detection, diagnosis and treatment of diseases have changed the approaches the healthcare industry uses to treat relatively common conditions that were previously untreated or under-treated, or that required hospitalization. Those conditions include asthma, diabetes, high cholesterol and hypertension.

Other highlights from the study:

•Â Enrollment in managed care plans nationwide grew from 12.5 million in 1983 to 105.3 million in 1998, making them the healthcare coverage of choice for most United States employers and their workers.

•Â The number of point-of-service enrollees and open-ended plans in-creased by more than 10% from 1994 to 1998, due to their added flexibility and wider choice. These plans now account for more members than all other types of managed care plans.

•Â The proportion of preferred provider organization plans that included a managed pharmacy program surged from 37% in 1990 to 80% in 1998.

•Â The total number of Medicare beneficiaries enrolled in HMO plans climbed from 1.4 million in 1986 to 6.5 million in 1998. In 1998, 17.3% of the nation's 37.6 million Medicare beneficiaries were enrolled in HMOs.

The report was created by tracking data and changes in HMO and PPO plans, pharmacy benefits and costs, utilization patterns, hospitals and health systems, integrated delivery systems, medical group practices, nursing homes and home care agencies. PR