Two-year changes in health and functional status among elderly Medicare beneficiaries in HMOs and fee-for-service.

摘要: Objective To compare two-year changes in health and functional status among a national sample of elderly Medicare beneficiaries risk-based HMOs fee-for-service. Data source Current Beneficiary Survey (MCBS) for 1995 to 1998. MCBS is longitudinal, in-person survey nation ally representative the population. Respondents are asked once year about status. Study design Noninstitutionalized respondents fall 1996 rounds whom follow-up data were available two years later included. Of sample, 1,126 members 3,449 fee-for-service at baseline. Ordered logistic regression binary used examine association HMO membership baseline with each measure or follow-up, controlling functioning other variables. Principal findings No significant differences found between respect status, either full subsets chronically ill respondents. there was little ef f ct on when analysis restricted persons who remained same care system (HMO fee-for-service) follow-up. Separate analyses 1995-97 1996-98 cohorts revealed some consistencies patterns change functioning. Conclusion There no consistent evidence an "HMO effect " enrollees over period.