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An evaluation of medical services for elderly members in the Social Health Maintenance Organization (SHMO) demonstrations is presented. The SHMOs generally failed to offer special geriatric medical services to the frail elderly, and the coordination of SHMO medical services with the special long-term care and case management services offered by the SHMOs was limited. These limitations led to some problems for the elderly in terms of access, continuity of care, and satisfaction. Variations in medical services occurred across sites, but generally the SHMOs established by mature HMO organizations appeared to offer more efficient and effective medical services than newly formed SHMOs.
Harrington et al. (Wed,) studied this question.