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AHCPR-Supported Study Finds Choice of Physician Specialist, System of Care, Unrelated to Outcomes for Treatment of Hypertension and Non-Insulin Dependent Diabetes

Press Release Date: November 6, 1995

A study supported by the Agency for Health Care Policy and Research and published in the November 8 issue of the Journal of the American Medical Association (JAMA) found there were no meaningful differences in health outcomes for patients with hypertension or for patients with non-insulin dependent diabetes mellitus (NIDDM), whether they were treated by different systems of care (e.g., fee-for-service, prepaid patients in solo/small single specialty groups, staff model HMOs) or by different physician specialists, including family practitioners, general internists, cardiologists or endocrinologists.

Sheldon Greenfield, M.D., with Tufts University Medical School in Boston and principal investigator for the study, said that although prepaid medicine tends to use fewer resources and rely to a larger extent on generalist physicians than does fee-for-service, there is no evidence from this study that the quality of care of mild to moderately ill patients with hypertension and NIDDM was adversely affected. "These findings must be viewed in light of the historically higher costs of fee-for-service medicine and of subspecialty physician practice and in the context of the continuing and rapid marketplace shift into managed care," Dr. Greenfield said.

Note: The JAMA article is entitled, "Outcomes of Patients With Hypertension and Non-Insulin Dependent Diabetes Mellitus Treated by Different Systems and Specialties: Results from the Medical Outcomes Study," by Sheldon Greenfield, M.D.; William Rogers, Ph.D.; Maureen Mangotich, M.D., M.P.H.; Maureen F. Carney, M.S.; and Alvin R. Tarlov, M.D..

For additional information, contact AHCPR Public Affairs: Karen Migdail, (301) 427-1855.

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