An Exploratory Study of the Effects of Medicare and Medicaid on Inpatient and Outpatient Care at Brookdale Hospital Center, Brooklyn, New York

Lisbeth W Orgel, Fordham University


Twenty Medicaid clinic patients at Brookdale Hospital were asked why they used the clinic rather than a private doctor. There was a great difference in the attitude toward clinic use between self-supporting patients and those on Public Assistance, the latter preferring clinic care to private medical care. There has been an increase in clinic attendance since Medicaid was enacted rather than the expected decrease. The increase in clinic patients seems to be due in part to an increase in self-supporting Medicaid patients who cannot find private doctors who will accept Medicaid and who, prior to the enactment of Medicaid, used private medical facilities to a great extent. These patients come to the clinic in order to take advantage of their Medicaid coverage, but some use a private doctor as well. A systematic sample of admission records at Brookdale Hospital from January 1, 1967, to December 31, 1967, was used to determine if Medicare patients were being admitted for a three-day stay. The same sampling procedure was followed when comparing the above patients to those hospitalized prior to Medicare for the period January 1, 1966, to June 30, 1966. This was done in order to determine if Medicare patients are hospitalized only so that they may be eligible for Extended Care benefits. Since the enactment of Medicare, there has been a general increase in the length of hospitalization of the elderly patient at Brookdale Hospital Center remaining for a period of 21 to 30 days and over. This has been an increase of 11.8 per cent. This may indicate that prior to Medicare those seriously ill patients who required such lengthy hospitalization were understaying in the hospital, possibly because of lack of hospital insurance. Many hospital insurance plans cover patients for a period of only 21 days, whereas Medicare covers an individual for a spell of illness for a period of 90 days. In a study made by the Health Insurance Institute, it was found that one out of every ten patients "overstays" in the hospital. This was due to the fact that some patients should be in nursing, convalescent, or chronic disease hospitals, and others should not have been admitted at all. The study also pointed out that long-term patients--those staying 30 days or more--make up a large percentage of the overstay patients. Another reason for an increased number of long stays in the hospital is that Extended Care facilities have become increasingly scarce, and many patients are not well enough to be at home while awaiting a bed at one of these facilities. Another contributing factor to the decrease in short stays may be due to the fact that, because of Medicare, those over 65 are going for private medical treatment which they could not have afforded previously, thus preventing the necessity for hospitalization. The efficient system of payments to doctors which has been developed has encouraged many physicians to treat Medicare patients. This attitude by doctors may be encouraging patients to continue treatment, which they may not have done before Title XVIII.

Subject Area

Public health|Health education

Recommended Citation

Orgel, Lisbeth W, "An Exploratory Study of the Effects of Medicare and Medicaid on Inpatient and Outpatient Care at Brookdale Hospital Center, Brooklyn, New York" (1968). ETD Collection for Fordham University. AAI30308719.