Managed care for congestive heart failure: Influence of payer status on process of care, resource utilization, and short-term outcomes

American Heart Journal

Volumn 136, Issue 3, 1998, Pages 553-561

  Philbin, E F ^a   DiSalvo, T G ^a  

^a HENRY FORD HOSPITAL   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ADOLESCENT; ADULT; AGED; ARTICLE; CHILD; CONGESTIVE HEART FAILURE; FEMALE; HEALTH CARE ACCESS; HEALTH CARE POLICY; HEALTH CARE QUALITY; HEALTH CARE UTILIZATION; HEALTH MAINTENANCE ORGANIZATION; HUMAN; MAJOR CLINICAL STUDY; MALE; MEDICARE; PRIORITY JOURNAL;

EID: 0031714776     PISSN: 00028703     EISSN: None     Source Type: Journal    
DOI: 10.1016/S0002-8703(98)70234-0     Document Type: Article

References (34)

1. V Tabbush G Swanson Changing paradigms in medical payment Arch Intern Med 156 1996 357 360
2. RH Miller HS Luft Managed care plan performance since 1980: a literature analysis JAMA 271 1994 1512 1519
3. DM Berwick Quality of health care, V: payment by capitation and the quality of care N Engl J Med 335 1996 1227 1231
4. MG Miller LS Miller B Fireman SB Black Variation in practice for discretionary admissions: impact on estimates of quality of hospital care JAMA 271 1994 1493 1498
5. DG Clement SM Retchin RS Brown MH Stegall Access and outcomes of elderly patients enrolled in managed care JAMA 271 1994 1487 1492
6. JE Ware WH Rogers AR Davies GA Goldberg RH Brook EB Keeler Comparison of health outcomes at a health maintenance organisation with those of fee-for-service care Lancet 1986 1017 1022
7. W Parmley Pathophysiology and current treatment of congestive heart failure J Am Coll Cardiol 13 1989 771 785
8. MJ Domanski R Garg S Yusuf Prognosis in congestive heart failure JD Hosenpud BH Greenberg Congestive heart failure: Pathophysiology, diagnosis and comprehensive approach to management 1994 Springer-Verlag New York 622 627
9. HM Krumholz EM Parent N Tu V Vaccarino Y Wang MJ Radford Readmission after hospitalization for congestive heart failure among Medicare beneficiaries Arch Intern Med 157 1997 99 104
10. Health Information Services 3M Health Care Financing Administration US Diagnosis related groups definitions manual 1993 3M Health Information Services Wallingford, Conn
11. ME Charlson P Pompei KL Ales CR MacKenzie A new method of classifying prognostic comorbidity in longitudinal studies: development and validation J Chron Dis 40 1987 373 383
12. M Charlson TP Szatrowski J Peterson J Gold Validation of a combined comorbidity index J Clin Epidemiol 47 1994 1245 1251
13. American Medical Association. Graduate Medical Education Directory 1995-1996. Chicago, Ill: American Medical Association.
14. EB Keeler LV Rubenstein KL Kahn D Draper ER Harrison MJ McGinty Hospital characteristics and quality of care JAMA 268 1992 1709 1714
15. AH Gradman PC Deedwania Predictors of mortality in patients with heart failure Cardiol Clin 12 1 1994 25 35
16. EF Philbin TA Rocco LJ Lynch VA Rogers P Jenkins Predictors and determinants of hospital length of stay in congestive heart failure in ten community hospitals J Heart Lung Transplant 16 1997 548 555
17. EF Philbin VA Rogers KA Sheesley LJ Lynch C Andreou TA Rocco The relationship between hospital length of stay and rate of death in heart failure Heart Lung 26 1997 177 186
18. SM Retchin B Brown Elderly patients with congestive heart failure under prepaid care Am J Med 90 1991 236 242
19. WG Manning A Leibowitz GA Goldberg WH Rogers JP Newhouse A controlled trial of the effect of a prepaid group practice on use of services N Engl J Med 310 1984 1505 1510
20. T Carey K Weis C Homer Prepaid versus traditional Medicaid plans: effects on preventive health care J Clin Epidemiol 43 1990 1213 1220
21. DG Safran AR Tarlov WH Rogers Primary care performance in fee-for-service and prepaid health care systems: results from the Medical Outcomes Study JAMA 271 1994 1579 1586
22. S Greenfield EC Nelson M Zubkoff W Manning W Rogers RL Kravitz Variations in resource utilization among medical specialists and systems of care: results from the Medical Outcomes Study JAMA 267 1992 1624 1630
23. RL Kravitz S Greenfield W Rogers WG Manning M Zubkoff EC Nelson Differences in the mix of patients among medical specialties and systems of care: results from the Medical Outcomes Study JAMA 267 1992 1617 1623
24. JS Weissman C Gatsonis AM Epstein Rates of avoidable hospitalization by insurance status in Massachusetts and Maryland JAMA 268 1992 2388 2394
25. RH Brook CJ Kamberg EA McGlynn Health system reform and quality JAMA 276 1996 476 480
26. JV Selby BH Fireman BE Swain Effect of a copayment on use of the emergency department in a health maintenance organization N Engl J Med 334 1996 635 641
27. N Lurie J Christianson M Finch I Moscovice The effects of capitation on health and functional status of the Medicaid elderly: a randomized trial Ann Intern Med 120 1994 506 511
28. TS Carey K Weis Diagnostic testing and return visits for acute problems in prepaid, case-managed Medicaid plans compared with fee-for-service Arch Intern Med 150 1990 2369 2372
29. KM Langa EJ Sussman The effect of cost-containment policies on rates of coronary revascularization in California N Engl J Med 329 1993 1784 1789
30. Council on Ethical Judicial Affairs American Medical Association Ethical issues in managed care JAMA 273 1995 330 335
31. EJ Emanuel NN Dubler Preserving the physician-patient relationship in the era of managed care JAMA 273 1995 323 329
32. MR Gold R Hurley T Lake T Ensor R Berenson A national survey of the arrangements managed-care plans make with physicians N Engl J Med 333 1995 1678 1683
33. DM Berwick Eleven worthy aims for clinical leadership of health system reform JAMA 272 1994 797 802
34. LI Iezzoni How much are we willing to pay for information about quality of care? Ann Intern Med 126 1997 391 393 [editorial]