This study used a national employee survey to test the hypothesis that symptomatic individuals in general, and individuals with depressive symptoms in particular, are disproportionately enrolled in fee-for-service health care plans as compared to health maintenance organizations (HMOs).
The study analyzed data from the 1993 Employee Health Care Value Survey, a questionnaire distributed to employees of three large corporations.
The sample comprised 20,283 employees covering six U.S. geographic regions and 46 health plans.
The authors used logistic regression to model the association between HMO enrollment and presence of physical and depressive symptoms, measured by subscales derived from the Medical Outcomes Study 36-item Short-Form Health Survey, adjusting for health, demographic, and insurance variables.
In unadjusted models, enrollees in fee-for-service plans had higher rates of both depressive and physical symptoms than HMO enrollees.
After adjustment for age alone or for age and other potential confounders, there was no difference in physical symptoms between plan types.
However, individuals with high levels of depressive symptoms were 16% less likely to be enrolled in HMOs than in fee-for-service plans after adjustment for age, other demographic variables, physical health status, and insurance characteristics. (...)
Mots-clés Pascal : Organisation santé, Soin intégré, Utilisation, Service santé, Santé mentale, Etat dépressif, Etats Unis, Amérique du Nord, Amérique, Homme, Trouble humeur
Mots-clés Pascal anglais : Public health organization, Managed care, Use, Health service, Mental health, Depression, United States, North America, America, Human, Mood disorder
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0358320
Code Inist : 002B18H05B. Création : 25/01/1999.