title: Switching Swiss enrollees from indemnity health insurance to managed care: the effect on health status and stisfaction with care.
abstract: OBJECTIVE
  In 1992, most members of a Swiss indemnity health insurance plan were automatically transferred into a newly created managed care organization. This study examined whether this semivoluntary change affected enrollees' health status and satisfaction with care.
  
  
  METHODS
  Three groups of enrollees were compared: 332 plan members who accepted the switch (managed care joiners); 186 plan members who opted to maintain indemnity coverage (non-joiners); and 296 persons continuosly enrolled in another indemnity plan (indemnity plan members). Health status, health related behaviors, and satisfaction with care received in the previous year were surveyed at baseline and 1 year later.
  
  
  RESULTS
  Health status remained unchanged in all three groups. Smoking prevalence decreased among managed care joiners but remained constant in the other groups. Satisfaction with insurance coverage increased between baseline and follow-up in managed care joiners, but decreased in nonjoiners and indemnity plan members. The latter groups had higher satisfaction with health care, particularly with continuity of care.
  
  
  CONCLUSIONS
  A semivoluntary switch from indemnity health insurance to managed care reduced satisfaction with health care but increased satisfaction with insurance coverage. There were no changes in self-perceived health status.
authors.affiliation: Institute of Social and Preventive Medicine, University of Geneva, Geneva, Switzerland.
authors.forename: T V
authors.initials: TV
authors.lastname: Perneger
authors.forename: J F
authors.initials: JF
authors.lastname: Etter
authors.forename: A
authors.initials: A
authors.lastname: Rougemont
mesh_terms: D000328:Adult; D005260:Female; D006264:Health Benefit Plans, Employee / Q000458:organization & administration*; D006302:Health Services Research; D006304:Health Status; D006801:Humans; D008297:Male; D008329:Managed Care Programs / Q000458:organization & administration*; D017060:Patient Satisfaction; D015995:Prevalence; D011446:Prospective Studies; D013557:Switzerland