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