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Article: The quality of care under a managed-care program for dual eligibles

TitleThe quality of care under a managed-care program for dual eligibles
Authors
KeywordsActivity of daily living
Medicaid
Medicare
Mortality
Preventable hospitalizations
Quality indicators
Issue Date2005
PublisherOxford University Press. The Journal's web site is located at http://gerontologist.gerontologyjournals.org
Citation
Gerontologist, 2005, v. 45 n. 4, p. 496-504 How to Cite?
AbstractPurpose: Our objective in this study was to compare the quality of care provided under the Minnesota Senior Health Options (MSHO), a special program designed to serve dually eligible older persons, to care provided to controls who received fee-for-service Medicare and Medicaid managed care. Design and Methods: Two control groups were used; one was drawn from nonenrollees living in the same area (Control-In) and another from comparable individuals living in another urban area where the program was not available (Control-Out). Cohorts living in the community and in nursing homes were included. Quality measures for both groups included mortality rates, preventable hospital admissions, and preventable emergency room (ER) visits. For the community group, nursing home admission rates were also tracked. For nursing home residents, quality measures included quality indicators derived from the Minimum Data Set. Results: There were no differences in mortality rates for either cohort. MSHO had fewer short-stay nursing home admissions but no difference for stays 90 days or longer. MSHO community and nursing home residents had fewer preventable hospital and ER visits compared to Control-In. There were no major differences in nursing home quality indicator rates. Implications: The cost of changing the model of care for dual eligibles from a mixture of fee-for-service and managed care to a merged managed-care approach cannot be readily justified by the improvements in quality observed. Copyright 2005 by The Gerontological Society of America.
Persistent Identifierhttp://hdl.handle.net/10722/137023
ISSN
2015 Impact Factor: 3.168
2015 SCImago Journal Rankings: 1.584
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorKane, RLen_HK
dc.contributor.authorHomyak, Pen_HK
dc.contributor.authorBershadsky, Ben_HK
dc.contributor.authorLum, Ten_HK
dc.contributor.authorFlood, Sen_HK
dc.contributor.authorZhang, Hen_HK
dc.date.accessioned2011-07-29T02:14:33Z-
dc.date.available2011-07-29T02:14:33Z-
dc.date.issued2005en_HK
dc.identifier.citationGerontologist, 2005, v. 45 n. 4, p. 496-504en_HK
dc.identifier.issn0016-9013en_HK
dc.identifier.urihttp://hdl.handle.net/10722/137023-
dc.description.abstractPurpose: Our objective in this study was to compare the quality of care provided under the Minnesota Senior Health Options (MSHO), a special program designed to serve dually eligible older persons, to care provided to controls who received fee-for-service Medicare and Medicaid managed care. Design and Methods: Two control groups were used; one was drawn from nonenrollees living in the same area (Control-In) and another from comparable individuals living in another urban area where the program was not available (Control-Out). Cohorts living in the community and in nursing homes were included. Quality measures for both groups included mortality rates, preventable hospital admissions, and preventable emergency room (ER) visits. For the community group, nursing home admission rates were also tracked. For nursing home residents, quality measures included quality indicators derived from the Minimum Data Set. Results: There were no differences in mortality rates for either cohort. MSHO had fewer short-stay nursing home admissions but no difference for stays 90 days or longer. MSHO community and nursing home residents had fewer preventable hospital and ER visits compared to Control-In. There were no major differences in nursing home quality indicator rates. Implications: The cost of changing the model of care for dual eligibles from a mixture of fee-for-service and managed care to a merged managed-care approach cannot be readily justified by the improvements in quality observed. Copyright 2005 by The Gerontological Society of America.en_HK
dc.languageengen_US
dc.publisherOxford University Press. The Journal's web site is located at http://gerontologist.gerontologyjournals.orgen_HK
dc.relation.ispartofGerontologisten_HK
dc.subjectActivity of daily livingen_HK
dc.subjectMedicaiden_HK
dc.subjectMedicareen_HK
dc.subjectMortalityen_HK
dc.subjectPreventable hospitalizationsen_HK
dc.subjectQuality indicatorsen_HK
dc.titleThe quality of care under a managed-care program for dual eligiblesen_HK
dc.typeArticleen_HK
dc.identifier.emailLum, T: tlum@hku.hken_HK
dc.identifier.authorityLum, T=rp01513en_HK
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.pmid16051912-
dc.identifier.scopuseid_2-s2.0-23044452882en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-23044452882&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume45en_HK
dc.identifier.issue4en_HK
dc.identifier.spage496en_HK
dc.identifier.epage504en_HK
dc.identifier.isiWOS:000230872100008-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridKane, RL=7402265271en_HK
dc.identifier.scopusauthoridHomyak, P=8679284000en_HK
dc.identifier.scopusauthoridBershadsky, B=6701611351en_HK
dc.identifier.scopusauthoridLum, T=8615080500en_HK
dc.identifier.scopusauthoridFlood, S=7003314916en_HK
dc.identifier.scopusauthoridZhang, H=7409197218en_HK

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