Effects of hospital-based primary care setting on internists' treatment of primary care episodes.

The amount of primary care provided at hospitals is increasing, yet little information exists on the relative costs of this form of care. To address this issue, we compared the treatment resources used by internists practicing in hospital-based and free-standing clinics. The study site was the Kaiser-Permanente Medical Care Program, Oregon Region. To control for case mix, the analysis focused on episodes of six specified conditions; upper respiratory infection, urinary tract infection, hypertension, abdominal pain, chest pain, and physical exam. The California Relative Value Schedule was used to define care intensity by summarizing the clinical, laboratory, and radiology services provided. Results indicate that setting exerts little influence on the intensity of primary care for the episodes studied; care of similar intensity is provided in hospital-based and free-standing settings.