Table 2 demonstrates enrollment in GBHC for the quarters analyzed for the entire GBHC eligible population and for the high-cost sample.
After identifying the high-cost sample, claims from October 1994 through September 1998 were analyzed to evaluate the effect of GBHC on per-person expenditures for the high-cost population compared other GBHC eligible aid-categories.
The per-person quarterly expenditures for the high-cost sample and for all continuously GBHC eligible Medicaid recipients (control group) are shown in Table 3.
The mean per-person expenditures for individuals enrolled with a GBHC provider and those not enrolled are provided by quarter for the high-cost sample and for the sample of continuously enrolled GBHC eligible individuals in Table 4.
It is difficult to assess the effect of GBHC on level of expenditures over time without adjusting for medical care cost inflation and seasonal variations in expenditures.
(1) LTE = [[beta].sub.1](Quarter)+ [[beta].sub.2](age) + [[beta].sub.3](GBHC) + [epsilon].
The estimate of [[beta].sub.3] in each regression demonstrates the relative effect of GBHC on quarterly costs.
Therefore, the results indicate that the effect of GBHC on reducing costs for the non-high-cost group (-0.197) is almost twice the effect for the high-cost group (-0.102) although GBHC appears to reduce total expenditures for both groups.
One of the primary goals of the GBHC program is to reduce excess utilization of emergency room services through increased access to primary care services provided in a physician's office.
Similarly, the ratio of total physician visits and inpatient days for the high-cost group and the control group of continuously eligible individuals demonstrates the relative effectiveness of the GBHC program in controlling physician visits and hospitalizations for the two groups.
The standard treatment for the last 30 years has been GBHC (Kwell, 1% lindane, Reed & Camrick, Piscataway, NJ). It is easy to apply, nonirritating, and more effective than older treatments including crotamiton 10% (Eurax, West-wood-Squibb, Princeton, NJ).[14,18] However, GBHC is absorbed through the skin, and may result in toxic serum levels in patients with thin or fissured skin, or with overuse, especially in elderly patients.
In a blinded clinical trial, 91% (64/70) of patients were cured with a single application of permethrin, but only 65% were cured (15/23) with GBHC. Longstanding scabies in extended care facilities is especially difficult to treat.