Abstract
There is considerable speculation on the causes of the frequently observed lower rates of hospital use by group practice--or HMO--members than by persons covered by other health care arrangements. It is often asserted that HMO enrollees are a self-selected healthier population, or that their use of hospitals is not fully recorded. A major study in California of the actual health and use of hospitals by a representative sample of persons under age 65 showed these assertions to be unfounded.

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