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The quality of care provided by HMOs varies substantially around the country, with HMOs in some regions using higher-quality facilities and other using lower-quality hospitals, according to a study by RAND of Santa Monica, CA.1
The researchers used expected-to-actual mortality rates for cardiac bypass surgery as a measure of hospital quality. In California, where health care markets are dominated by managed care, the HMOs directed patients to hospitals with lower-than-expected mortality rates. In Florida, where managed care is less established, users of the traditional Medicare program were more likely to receive treatment from hospitals with lower mortality rates than Medicare HMO patients.
1. Escarce JJ, Horn RL, Pauly MV, Williams SV, et al. Health maintenance organizations and hospital quality of care for coronary artery bypass surgery. Med Care Res Rev 1999; 56:340-362.
Less than half (43%) of patients take their medication as prescribed, and it’s worse for those with asthma (34%), back problems (36%), depression (28%), and migraines (28%), according to an on-line survey by Harris Interactive of Rochester, NY. The study included responses from more than 10,000 chronically ill adults.
Insurance coverage influenced compliance with medication use. Not surprisingly, those without coverage for prescriptions were less likely to have them filled, the study found.