Document Detail

A comparison of ambulatory services for patients with managed care and fee-for-service insurance.
MedLine Citation:
PMID:  11853205     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: To determine whether family physicians provide different ambulatory care to patients with health insurance from managed care organization (MCO) versus fee-for-service (FFS) plans. STUDY DESIGN: Multimethod cross-sectional observational study. PATIENTS AND METHODS: A total of 4454 patients made office visits to 138 family physicians in northeastern Ohio. Direct observation with the Davis Observation Code and a structured checklist were used to assess the process of care. Patient satisfaction was measured with the Medical Outcomes Study 9-Item Visit Rating Form. RESULTS: Among 1588 patients with MCO insurance and 876 with FFS insurance, no differences were noted in the number of visits per year, length of visits, percentage of visits for well care, or the percentage of visits in which medicines were prescribed in analyses controlling for patient mix. Visits by patients with MCO insurance were more likely to involve referrals to another physician than visits by patients with FFS insurance. Patient satisfaction and time use during visits were comparable for the 2 groups. CONCLUSIONS: Managed care insurance appears to increase involvement of the primary care provider in the referral process. However, in a healthcare market with moderate managed care penetration in which the same physicians see patients with different types of insurance, the process of care is affected little by type of insurance coverage.
George E Kikano; Clint W Snyder; Edward J Callahan; Meredith A Goodwin; Kurt C Stange
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  The American journal of managed care     Volume:  8     ISSN:  1088-0224     ISO Abbreviation:  Am J Manag Care     Publication Date:  2002 Feb 
Date Detail:
Created Date:  2002-02-20     Completed Date:  2002-03-14     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  9613960     Medline TA:  Am J Manag Care     Country:  United States    
Other Details:
Languages:  eng     Pagination:  181-6     Citation Subset:  H    
Department of Family Medicine, Ireland Cancer Center, Case Western Reserve University, Cleveland, OH 44106-4950, USA.
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MeSH Terms
Ambulatory Care / organization & administration*
Cross-Sectional Studies
Family Practice / organization & administration*
Fee-for-Service Plans*
Health Services Research
Managed Care Programs*
Office Visits
Patient Satisfaction / statistics & numerical data
Process Assessment (Health Care)
Utilization Review
Grant Support

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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