Study shows variable quality of care by HMOs
A review of a series of studies conducted between 1993 and 1997 shows that the quality of care provided by managed care organizations varies depending on the organization providing care and the particular patient condition. Researchers Robert H. Miller and Harold S. Luft from the University of California in San Francisco analyzed 37 peer-reviewed studies on managed care organizations, most of which were health maintenance organizations. The study was published in the Sept./Oct. 1997 issue of Health Affairs, published by Project Hope in Bethesda, MD. (See editor’s note, p. 11, for ordering information.)
Results are mixed
The results did not definitively support or oppose managed care, even though there were cases in which Medicare HMO enrollees with chronic conditions received the worst quality of care, conclude Miller and Luft.
Miller and Luft explain that, because there are so few studies, and because those which do exist vary greatly in scope and methods, it is difficult to interpret and generalize the available data.
They also cite the need for more detailed clinical and organizational data. They explain that in the absence of data, anecdotes are used as evidence. Those anecdotes typically are unfavorable to HMOs, whereas study results may present a more mixed pattern.
[Editor’s note: Individual articles in Health Affairs can be purchased for $12. Ask for the article, "Does Managed Care Lead to Better or Worse Quality of Care?" All orders must be prepaid and will be e-mailed (in PDF format) or faxed once payment has been verified. To receive an article by mail or to order by phone, contact Judie Tucker at (301) 656-7401, ext. 200. Fax: (301) 654-2845. Or write: Health Affairs, 7500 Old Georgetown Road, Suite 600, Bethesda, MD 20814. E-mail: [email protected]. World Wide Web: http://www.projhope.org/.] t
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