To determine the effect of a self-care communication-based health education program on ambulatory care utilization, a prospective, randomized, controlled trial was conducted with a Medicare population within a health maintenance organization. A statistically significant decrease of 15% in total medical visits was found in the experimental group as compared with a control. Although not evident in the control, a statistically significant decrease in the ratio of follow-up visits from pre-entry to postentry was realized in the experimental group. Medical-visit decreases resulted in a savings of $36.65 per household in the experimental group for a benefit-cost ratio of 2.19 saved for every dollar spent on intervention. These results demonstrate that a health education program can reduce utilization while having no known negative impact on the quality of health.
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Vickery et al. (1988) studied this question.