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  1. Fulltext. The effect of managed care on quality : A review of recent evidence.

    Article - En anglais


    This article reviews recent evidence about the relationship between managed care and quality.

    With one exception, the studies reviewed represent observation periods that extend through 1990 or a more recent year.

    The review has led to the conclusion that managed care has not decreased the overall effectiveness of care.

    However, evidence suggests that managed care may adversely affect the health of some vulnerable subpopulations.

    Evidence also suggests that enrollees in managed care plans are less satisfied with their care and have more problems accessing specialized services.

    In addition, younger, wealthier, and healthier persons were more satisfied with their health plans than older, poorer, and sicker persons, even after adjusting for the type of health plan.

    The findings of the studies reviewed do not provide definitive results about the effect of managed care on quality.

    Indeed, relatively few studies include data from the 1990s, and little is known about the newer types of health maintenance organizations that invest heavily in information systems and rely on financial incentives to alter practice patterns.

    Furthermore, managed care is not a uniform method that is applied identically by all health plans, and research studying the different dimensions of managed care also is needed.

    Mots-clés Pascal : Soin intégré, Facteur qualité, Randomisation, Satisfaction, Relation médecin malade, Article synthèse, Etats Unis, Amérique du Nord, Amérique, Homme, Organisation santé

    Mots-clés Pascal anglais : Managed care, Q factor, Randomization, Satisfaction, Physician patient relation, Review, United States, North America, America, Human, Public health organization

    Logo du centre Notice produite par :
    Inist-CNRS - Institut de l'Information Scientifique et Technique

    Cote : 98-0238559

    Code Inist : 002B30A01C. Création : 11/09/1998.