Foundation for Medical Care Control of Hospital Utilization: CHAP — A PSRO Prototype

Operating concurrently with a California government program to control hospital utilization in a Medicaid program is the Certified Hospital Admission Program (CHAP), carried out by the Sacramento County Medical Society through its Medical Care Foundation. During the CHAP eight-month study period, May through December, 1970, the observed hospital days of stay declined nearly 17 per cent. The observed number of admissions declined more than 11 per cent, and the average length of stay decreased from 4.7 to 4.4 days —6.4 per cent below the expected number. These reductions exceeded those found in comparable areas where a similar control program was operated by the California state government. Thus, CHAP not only has proved to be as effective as the government-operated program, but has the added dimension of being operated by a medical society, free from direct government intervention. (N Engl J Med 288:878–882, 1973)