Managed Care
July 1, 2000 less than 1 minute read
Managed Care
Special report
By Stan Deresinski, MD, FACP
Some months ago, i received a communication dealing with antibiotic use from Health Net. Health Net calls itself "California’s Health Plan" and, on its Web site, describes itself in the following way: "We have an extensive network of nearly 45,000 physicians, 750 physician groups and affiliates, and 4200 pharmacies—all working together to serve nearly 2.2 million Members. Health Net has grown to become the largest subsidiary of Foundation Health Systems (FHS), the fourth largest publicly traded managed care organization in the United States."
The communication contained a listing of "Health Net Suggested Treatment for Respiratory Tract Infections." For patients with acute exacerbations of chronic bronchitis, it states "Antibiotics are usually not required" and gives as a citation JAMA 1995;273:957.1 Saint and colleagues, however, state a different conclusion in that article: "These analyses suggest a small but statistically significant improvement due to antibiotic therapy in patients with exacerbations of COPD. This antibiotic-associated improvement may be clinically significant, especially in patients with low baseline flow rates."
Although there is some room for interpretation of the results of this study, they bring one to a conclusion far different from "antibiotics are usually not required." If Health Net is "California’s Health Plan," it may be time to move to a state with a health plan that is more careful in its pronouncements.
Reference
1. Saint S, et al. JAMA 1995;273:957-960.
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