Physician perceptions of HMO care for older persons. Health Maintenance Organization.
OBJECTIVE
Physician attitudes may be a key factor in effective managed care for older patients. We sought to explore physicians' views of the influence of health maintenance organization (HMO) policies on the care of their older patients.


METHODS
A self-administered one-page questionnaire consisting of questions about physician demographics, the impact of HMOs on physician practice, patient care, HMO policies, and respondents' personal use of managed health care plans.


METHODS
The survey was mailed to 838 randomly selected primary care physicians affiliated with two large, nonprofit, academically-oriented, Medicare HMOs in Massachusetts.


RESULTS
Completed surveys were received from 516 of 797 eligible primary care physicians, affiliated with either Secure Horizons (Tufts Associated Health Plan) or First Seniority (Harvard Pilgrim Health Care). About half (55%) of the physician respondents reported they had sufficient time to spend with their older patients. Most (81%) respondents indicated that overall, patients aged 65 and older received either better care or no change in care after joining an HMO. The majority of physicians reported that HMO affiliation had increased the frequency with which they addressed geriatric issues with their older patients. There were several patterns of response that emerged with respect to beliefs about key HMO policies.


CONCLUSIONS
The majority of physicians working in two nonprofit, academically oriented Medicare HMOs in Massachusetts believed that the overall quality of care that older patients received after joining an HMO either did not change or improved.
Dixon
M K
MK
Gerontology Division, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA.
Kirschner
P B
PB
Edelberg
H K
HK
Ayanian
J Z
JZ
Wei
J Y
JY
D000368:Aged; D001291:Attitude of Health Personnel; D003625:Data Collection; D005260:Female; D006279:Health Maintenance Organizations; D006299:Health Services for the Aged / Q000458:organization & administration*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008404:Massachusetts; D006278:Medicare / Q000458:organization & administration*; D015999:Multivariate Analysis; D016134:Organizational Policy; D010818:Practice Patterns, Physicians'; D011320:Primary Health Care; D011787:Quality of Health Care; D014481:United States