The American journal of managed care
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To describe adherence to a number of quality indicators and clinical outcomes for asthma, diabetes mellitus, hypertension, coronary heart disease, atrial fibrillation, and cerebrovascular disease in the primary care practices of the Practice Partner Research Network (PPRNet). ⋯ The findings of this study are comparable to others in documenting that most clinical practice guidelines for chronic illness are not followed for a majority of patients and that large majorities do not reach desired clinical outcomes.
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To determine if patients perceived a difference in the efficacy, side effects, and value of omeprazole versus lansoprazole for gastroesophageal reflux disease (GERD) maintenance therapy after a formulary conversion, and to evaluate the costs of the conversion. ⋯ Omeprazole was the medication preferred by patients for GERD maintenance therapy. Patients were willing to pay an additional fee for their preferred agent. Fewer adverse events were reported with omeprazole. The potential cost savings of the formulary conversion may have been at the expense of patient satisfaction.
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To demonstrate the potential value and current limitations of using resource allocation models for selecting health services. ⋯ Resource allocation models have the potential for assisting MCOs in selecting a set of preventive services that will maximize population health. Before this potential can be fully realized, additional methodological development and cost-effectiveness studies are needed. The use of resource allocation should be examined for selecting all healthcare services.
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To evaluate the clinical, financial, and parent/patient satisfaction impact of critical pathways on the postoperative care of pediatric cardiothoracic patients with simple congenital heart lesions. ⋯ Implementation of critical pathways reduced resource utilization and costs after repair of three simple congenital heart lesions, without obvious complications or patient dissatisfaction.
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To identify healthcare utilization characteristics that distinguish female members of a managed care organization (MCO) who remained compliant with hormone replacement therapy (HRT) from those who had poor compliance during an 18-month period and to estimate the cost of HRT to an MCO. ⋯ The added cost of HRT did not result in higher total healthcare utilization and costs, as women who complied well with therapy had decreased utilization and costs in other categories of care. Differences in subcategories of healthcare utilization suggest that level of HRT compliance reflects differences in how women access healthcare.