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April 1, 2003Health Services ResearchOpen Access

Chronic Disease Medication Use in Managed Care and Indemnity Insurance Plans

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Why the study?

Does managed care insurance compared to indemnity insurance increase the use of chronic disease medications in adult patients with diabetes, heart failure, or asthma?

Population

44,272 adult patients with diabetes mellitus, congestive heart failure, or asthma identified by ICD-9 codes…

Comparison

Independent practice association model managed… vs Indemnity insurance plans (2 plans)

Design

Cross-sectional

Authors

RSRandall S. StaffordPreventive CardiologySDStephen M. DavidsonNHS LanarkshireHDHarriet DavidsonSt George's, University of London

Discussion

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Member takes

Implication

Should not yet change practice; leaves open whether managed care causally improves adherence or outcomes.

Structured PICO

Does managed care insurance compared to indemnity insurance increase the use of chronic disease medications in adult patients with diabetes, heart failure, or asthma?

P
Population
44,272 adult patients with diabetes mellitus (n=26,444), congestive heart failure (n=7,978), or asthma (n=9,850) identified by ICD-9 codes from 1997 claims data.
I
Intervention
Independent practice association (IPA) model managed care insurance plans (3 plans)
C
Comparator
Indemnity insurance plans (2 plans)
O
Outcome
Use of chronic disease medications (defined through pharmacy claims for patients receiving one or more prescriptions for drugs used in treating these conditions)

Managed care plans are associated with higher utilization of chronic disease medications compared to indemnity plans, though overall condition-specific medication use remains relatively low in both models.

Cite This Study

Stafford et al. (2003) studied this question.

synapsesocial.com/papers/6a8945f29be9d02581bd52behttps://doi.org/10.1111/1475-6773.00135

Topics

Heart failureHFrEF treatment
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Does Managed Care Lead To Better Or Worse Quality Of Care?1997 · 453 citations
  2. 2ACC/AHA Guidelines for the Evaluation and Management of Chronic Heart Failure in the Adult: Executive Summary A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to Revise the 1995 Guidelines for the Evaluation and Management of Heart Failure)2001 · 1,443 citations
  3. 3Treatment of Congestive Heart Failure2001 · 81 citations
  4. 4Managed care plan performance since 1980: another look at 2 literature reviews.1999 · 36 citations
  5. 5Managed Care Plan Performance Since 19801994 · 587 citations