Hospitalization and mortality rates for peptic ulcers: a comparison of a large health maintenance organization and United States data.

Hospital discharge and mortality rates for peptic ulcer disease from 1970-1980 for a large Health Maintenance Organization, the Kaiser-Permanente Medical Care Program of Southern California, are compared with the corresponding rates for the United States. The Kaiser-Permanente Medical Care Program hospitalization and mortality age-adjusted rates for ulcers are well below the national rates. In comparison with the 25%-31% decline in the national ulcer hospitalization rate, the Kaiser-Permanente Medical Care Program rate has been relatively stable. Most of the decline in national ulcer hospitalizations is due to a decrease in hospitalizations for uncomplicated cases. The Kaiser-Permanente Medical Care Program uncomplicated hospitalization rates are less than 25% of the national rate after age-adjustment and have been relatively stable over time. The age-adjusted Kaiser-Permanente Medical Care Program rates for ulcers with hemorrhages and perforations are 77% of the national data. These data suggest that part of the decline in national hospitalization rates for peptic ulcer disease may be due to changes in medical management and hospitalization criteria. In addition, this study supports the results of other studies which show that hospitalization rates are lower in Health Maintenance Organizations than in non-Health Maintenance Organizations with no apparent adverse impact on outcome.