Poor, elderly fare worse in HMOs than in traditional health plans.Health maintenance organizations (HMOs) may be bad for the health of people who need care the most, according to according to prep. 1. As stated or indicated by; on the authority of: according to historians. 2. In keeping with: according to instructions. 3. a study published in the journal of the American Medical Association JAMA: The Journal of the American Medical Association is an international peer-reviewed general medical journal, published 48 times per year by the American Medical Association. JAMA is the most widely circulated medical journal in the world. . The study found that elderly people and poor people who are chronically ill "were more than twice as likely to decline in health in an HMO HMO health maintenance organization. HMO n. A corporation that is financed by insurance premiums and has member physicians and professional staff who provide curative and preventive medicine within certain financial, " than in a fee-for-service plan. (John E. Ware Jr. et al., Differences in Four-Year Health Outcomes for Elderly and Poor, Chronically Ill Patients, 276 JAMA JAMA abbr. Journal of the American Medical Association 1039 (1996).) The American Association American Association refers to one of the following professional baseball leagues:
A spokesman for the group said Ware's study "seems to be at odds" with other studies that show the care for chronically ill elderly and poor people in HMOs "to be as good or better than care in fee-for-service settings." Ware's study, which involved self-reporting by participants rather than diagnostic testing Diagnostic testing Testing performed to determine if someone is affected with a particular disease. Mentioned in: Von Willebrand Disease , showed that among elderly patients, 54 percent using HMOs and 28 percent using fee-for-service plans said that they experienced a decline in physical health. Among poor people, the statistics were similar. The researcher noted that patients under age 65 who weren't poor reported no significant difference in health outcomes, regardless of the type of health care plan used. No Surprise Kevin Smith, a plaintiffs' lawyer in West Palm Beach, Florida West Palm Beach, also known as West Palm, is the most populous city in Palm Beach County, Florida, USA. The city is also the oldest incorporated municipality in South Florida. According to the University of Florida's 2006 estimates, the city had a population of 107,617. , said the study results regarding elderly and poor people are not surprising. "I certainly agree with the premise," said Smith, who has litigated several cases of HMO abuse. "Of all the cases I've handled they either involved old people, poor people, or poor old people. I understand that we've got a health care crisis in general, but a lot of HMOs are poorly run." At the conclusion of the study, Ware urged that an independent "consumer report" be created on the quality of care for each HMO and each fee-for-service health insurance plan. "The [study] results indicate that all HMOs are not created equal," he said. The goal of the study was to compare physical and mental health outcomes of chronically ill adults, including elderly and poor people, treated in HMOs and fee-for-service systems. The researchers looked at 2,235 patients in Boston, Chicago, and Los Angeles from 1986 to 1990. The patients, aged 18 to 97 years (the mean age was just under 58), suffered from chronic hypertension, non-insulin dependent diabetes, congestive heart failure congestive heart failure, inability of the heart to expel sufficient blood to keep pace with the metabolic demands of the body. In the healthy individual the heart can tolerate large increases of workload for a considerable length of time. , depression, or a recent heart attack. Copies of the study are available on the Internet at http:// www.ama-assn. org/ under the heading "Scientific Journals and News." |
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