TreatmentUpdate 72, Vol. 8, No. 8; October 1996
Sean Hosein

Over the past 5 years doctors in the US have found that increasing numbers of their patients have their medical bills paid for by agencies called HMOs (health maintenance organizations). Today HMOs are large, covering tens of thousands of patients, are increasingly influential, and can force doctors to reduce their fees. This in turn cuts the costs to the HMOs and lowers the income of doctors. Some doctors complain about HMOs which don't allow them to order certain expensive tests, carry out costly procedures or prescribe high-priced drugs, even if these options are in the best interests of their patients. This system of health care run by HMOs is called managed care. One team of doctors has been monitoring 1,000 men with HIV/AIDS to find out the effect managed care has on their health.

Results

The doctors found that 50% of men who had AIDS at the time they entered the study or who developed AIDS while in the study lived for 17 months under managed care. The equivalent figure for men who were in the traditional fee for service system (which exists in Canada) was 30 months. This difference -- an increase in survival time of 60% -- was [statistically] significant, that is; not likely caused by chance alone.

REFERENCES:

1. Palenick J, Graham NMH, Wu A, et al . Poorer survival among AIDS patients enrolled in managed care organisations versus traditional indemnity insurance. Abstract N024.

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