Management of colorectal cancer in Medicare health maintenance organizations.
Because of the financial incentives of prepaid care, the quality of care for Medicare enrollees in Health Maintenance Organizations (HMOs) is a concern. Therefore, the care in 150 newly diagnosed cases of colorectal cancer in eight HMOs was compared with that in 180 similar fee-for-service (FFS) cases. As part of the diagnostic workup, HMO patients were more likely to have had fecal occult blood tests (74% vs 52%, p less than 0.01) and endoscopy or barium enemas (97% vs 90%, p less than 0.05). FFS patients were more likely to have had preoperative imaging studies (54% vs 38%, p less than 0.01). Although there were longer diagnostic delays for HMO enrollees with gastrointestinal bleeding, there were no significant differences in disease stage or clinical status, and postoperative follow-up was similar. The authors conclude that enrollees in Medicare HMOs with colorectal cancer receive medical and surgical care at least equal to that received in FFS settings.
Retchin
S M
SM
Department of Medical Medical College of Virginia, Virginia Commonwealth University, Richmond.
Brown
B
B
D000368:Aged; D015179:Colorectal Neoplasms / Q000191:economics* / Q000628:therapy; D005251:Fees, Medical; D005260:Female; D006279:Health Maintenance Organizations / Q000592:standards*; D006295:Health Resources / Q000706:statistics & numerical data; D006760:Hospitalization; D006801:Humans; D008297:Male; D006278:Medicare / Q000458:organization & administration*; D011787:Quality of Health Care / Q000706:statistics & numerical data*; D014481:United States