Primary Care Performance in Fee-for-Service and Prepaid Health Care Systems: Results From the Medical Outcomes Study

JAMA: The Journal of the American Medical Association

Volumn 271, Issue 20, 1994, Pages 1579-1586

  Safran, Dana Gelb ^a   Tarlov, Alvin R ^a   Rogers, William H ^a  

^a TUFTS UNIVERSITY   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ADULT; ARTICLE; CHRONIC DISEASE; DEMOGRAPHY; FEMALE; GROUP PRACTICE; HEALTH CARE ACCESS; HEALTH CARE DELIVERY; HEALTH CARE QUALITY; HEALTH CARE UTILIZATION; HEALTH INSURANCE; HEALTH MAINTENANCE ORGANIZATION; HUMAN; LONGITUDINAL STUDY; MAJOR CLINICAL STUDY; MALE; PHYSICIAN; PRIMARY MEDICAL CARE; PRIORITY JOURNAL; QUESTIONNAIRE;

EID: 0028359244     PISSN: 00987484     EISSN: 15383598     Source Type: Journal    
DOI: 10.1001/jama.1994.03510440039030     Document Type: Article

References (58)

1. US General Accounting Office. Medicaid: States Turn to Managed Care to Improve Access and Control Costs. Washington DC: US General Accounting Office; 1993.
2. Gable J, Rice T. Is managed competition a field of dreams? J Am Health Policy. 1993;1:19-24.
3. Luft HS. How do health-maintenance organizations achieve their 'savings'? N Engl J Med. 1978; 298:1336-1343.
4. Manning WG, Leibowitz A, Goldberg GA, et al. A controlled trial of the effect of a prepaid group practice on use of services. N Engl J Med. 1984; 310:1505-1510.
5. Greenfield S, Nelson EC, Zubkoff M, et al. Variations in resource utilization among medical specialties and systems of care: Results from the Medical Outcomes Study. JAMA. 1992;267:1624-1630.
6. Spitz B. When a solution is not a solution: Medicaid and health maintenance organizations. J Health Polit Policy Law. 1979;3:497-518.
7. Rowland D, Lyons B. Mandatory HMO care for Milwaukee's poor. Health Aff (Millwood). 1987;6: 87-100.
8. Schlesinger M. On the limits of expanding health care reform: Chronic care in prepaid settings. Milbank Q. 1986;64:189-215.
9. Luft JS. Health Maintenance Organizations: Dimensions of Performance. New York, NY: John Wiley & Sons Inc; 1981.
10. Ware JE Jr, Brook RH, Rogers WH, et al. Comparison of health outcomes at a health maintenance organization with those of fee-for-services care. Lancet. 1986;1:1017-1022.
11. Rubin HR, Gandek B, Rogers WH, Kosinski M, McHorney CA, Ware JE Jr. Patients' ratings of outpatient visits in different practice settings: Results from the Medical Outcomes Study. JAMA. 1993;270:835-840.
12. Institute of Medicine. Report of a Study: A Manpower Policy for Primary Health Care. Washington DC: National Academy of Sciences; May 1978.
13. Tarlov AR, Ware JE Jr, Greenfield S, Nelson EC, Perrin E, Zubkoff M. The Medical Outcomes Study: An application of methods for monitoring the results of medical care. JAMA. 1989;262:925-930.
14. Kravitz RL, Greenfield S, Rogers WH, et al. Differences in the mix of patients among medical specialties and systems of care: Results from the Medical Outcomes Study. JAMA. 1992;267:1617-1623.
15. Rogers WH, McGlynn E, Berry S, et al. Methods of sampling. In: Stewart AL, Ware JE, eds. Measuring Functioning and Well-being: The Medical Outcomes Study Approach. Durham, NC: Duke University Press; 1992.
16. Ware JE, Snyder MK, Wright WR. Part B: Results regarding scales constructed from the patient satisfaction questionnaire and measures of other health perceptions. In: Development and Validation of Scales to Measure Patient Satisfaction With Health Care Services, I. Springfield, Va: National Technical Information Services; 1976. NTIS publication PB 288-330.
17. Davies AR, Ware JE, Brook RH, et al. Consumer acceptance of prepaid and fee-for-service medical care: Results from a randomized controlled trial. Health Serv Res. 1986;21:429-452.
18. Aday LA, Anderson R. Process and outcome indicators of access. In: Access to Medical Care. Ann Arbor, Mich: Health Administration Press; 1975:15-35.
19. Aday LA, Anderson R, Fleming GV. A theoretical framework for the study of access to medical care. In: Health Care in the US: Equitable for Whom? Beverly Hills, Calif: Sage Publications; 1980: 25-45.
20. Davies AR, Ware JE. Involving consumers in quality of care assessment. Health Aff (Millwood). 1988;7:33-48.
21. Office of Technology Assessment. Patients' assessments of their care. In: The Quality of Medical Care: Information for Consumers. Washington, DC: US Government Printing Office; 1988.
22. Corah NL, O'Shea RM, Pace LF, et al. Development of a patient measure of satisfaction with the dentist: The dental visit satisfaction scale. J Behav Med. 1984;7:367-373.
23. Gerbert B, Hargreaves WA. Measuring physician behavior. Med Care. 1986;24:838-847.
24. Welch WP. The new structure of individual practice associations. J Health Polit Policy Law. 1987;12:723-739.
25. Rao CR. Estimation of variance and covariance components in linear models. J Am Stat Assoc. 1975;67:112-115.
26. Huber PJ. The behavior of maximum likelihood estimators under non-standard conditions. In: Proceedings of the Fifth Berkeley Symposium. Berkeley: University of California Press; 1965:221-233.
27. Davies AR. Selection of prepaid or fee-for-service care by Medicaid families. Adv Health Econ Health Serv Res. 1989;10:183-198.
28. Lairson DR, Herd JA. The role of health practices, health status, and prior health care claims in HMO selection bias. Inquiry. 1987;24:276-284.
29. Wilensky GR, Rossiter LF. Patient self-selection in HMOs. Health Aff (Millwood). 1986;5:66-80.
30. Jackson-Beeck M, Kleinman JH. Evidence for self-selection among health maintenance organization enrollees. JAMA. 1983;250:2826-2829.
31. Bonferroni CE. Il calcolo delle assicurazioni su gruppi di teste. In: Studii in Onore del Prof. Rome, Italy: S. O. Carboni; 1936.
32. Wolinsky FS, Marder WD. Waiting to see the doctor: The impact of organizational structure of medical practice. Med Care. 1983;21:531-542.
33. Mechanic D. The organization of medical practice and practice orientation among physicians in prepaid and nonprepaid primary care settings. Med Care. 1975;13:189-204.
34. Held P, Reinhard U. Analysis of Economic Performance in Medical Group Practices. Princeton, NJ: Mathematica Policy Research; 1979.
35. Mechanic D, Weiss N, Cleary PD. The growth of HMOs: Issues of enrollment and disenrollment. Med Care. 1983;21:338-347.
36. Murray JP. A follow-up comparison of patient satisfaction among prepaid and fee-for-service patients. J Fam Pract. 1988;26:576-581.
37. Hennelly VD, Boxerman SB. Continuity of medical care: Its impact on physician utilization. Med Care. 1979;17:1012-1018.
38. Starfield BH, Simborg DW, Horn DS, Yourtree SA. Continuity and coordination in primary care: Their achievement and utility. Med Care. 1976;14: 625-636.
39. Wasson JH, Sauvigne AE, Mogielnicki RP, et al. Continuity of outpatient medical care in elderly men: A randomized trial. JAMA. 1984;252:2413-2417.
40. Lofgren RP, Gottlieb D, Williams RA, Rich EC. Post-call transfer of resident responsibility. J Gen Intern Med. 1990;5:501-505.
41. Becker MH, Drachman RH, Kirscht JP. Continuity of pediatrician: New support for an old shibboleth. J Pediatr. 1974;84:599-605.
42. Becker MH, Drachman RH, Kirscht JP. A field experiment to evaluate various outcomes of continuity of physician care. Am J Public Health. 1974; 64:1062-1070.
43. Poland ML. The effects of continuity of care on the missed appointment rate in a prenatal clinic. J Obstet Gynecol Neonatal Nurs. 1976;5:45-47.
44. Charney E, Bynum R, Eldredge D, et al. How well do patients take oral penicillin? a collaborative study in private practice. Pediatrics. 1967;40:188-195.
45. Becker MH, Drachman RH, Kirscht JP. Predicting mothers' compliance with pediatric medical regimens. J Pediatr. 1972;81:843-854.
46. Becker MH, Drachman RH, Kirscht JP. A new approach to explaining sick-role behavior in low-income populations. Am J Public Health. 1974;64: 205-216.
47. Shortell SM, Richardson WC, LoGerfo JP, et al. The relationships among dimensions of health services in two provider systems: A causal model approach. J Health Soc Behav. 1977;18:139-159.
48. Breslau N, Mortimer EA Jr. Seeing the same doctor: Determinants of satisfaction of 'specialty' care for disabled children. Med Care. 1981;19:741-758.
49. Aiken LH, Lewis CE, Craig J, et al. The contribution of specialists to the delivery of primary care: A new perspective. N Engl J Med. 1979;30: 1363-1370.
50. Eisenberg JM. The internist as gatekeeper: Preparing the general internist for a new role. Ann Intern Med. 1985;102:537-543.
51. Roulidis ZC, Schulman K. Role of the gatekeeper in managed care: Theory or reality? Presented at the 10th Annual Conference of the Association for Health Services Research; June 28, 1993; Washington, DC.
52. Marquis MS, Davies AR, Ware JE Jr. Patient satisfaction and change in medical care provider: A longitudinal study. Med Care. 1983;21:821-829.
53. Ware JE JR, Davies AR. Behavior consequences of consumer dissatisfaction with medical care. Eval Program Plann. 1983;6:291-297.
54. Kasteller J, Kane RL, Olsen D. Issues underlying prevalence of 'doctor-shopping' behavior. J Health Soc Behav. 1975;17:328-339.
55. DiMatteo MR, DiNicola DD. Achieving Patient Compliance. New York, NY: Pergamon Press Inc; 1982.
56. Sherbourne CD, Hays RD, Ordway L, et al. Antecedents of Adherence to Medical Recommendations: Results From the Medical Outcomes Study. Santa Monica, Calif: RAND; 1991.
57. Garrity T. Medical compliance and the clinician-patient relationship: A review. Soc Sci Med. 1981; 15:215-222.
58. Hillman AL, Welch WP, Pauly MV. Contractual arrangements between HMOs and primary care physicians: Three-tiered HMOs and risk pools. Med Care. 1992;30:136-148.