The American journal of managed care
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Randomized Controlled Trial Clinical Trial
A randomized trial of nurse specialist home care for women with high-risk pregnancies: outcomes and costs.
To examine prenatal, maternal, and infant outcomes and costs through 1 year after delivery using a model of prenatal care for women at high risk of delivering low-birth-weight infants in which half of the prenatal care was provided in women's homes by nurse specialists with master's degrees. ⋯ This model of care provides a reasoned solution to improving pregnancy and infant outcomes while reducing healthcare costs.
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Randomized Controlled Trial Comparative Study Clinical Trial
Effect of rofecoxib therapy on measures of health-related quality of life in patients with osteoarthritis.
Bodily pain and physical disability can negatively impact health-related quality of life (HRQL) in patients with osteoarthritis (OA). ⋯ Rofecoxib treatment increased physical and mental HRQL domain scores on the SF-36. Improvements in mental health with rofecoxib use primarily resulted from effective treatment of OA (i.e., reduction in pain and improvement in physical function).
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To assess patient satisfaction and a health plan's return on investment associated with a telephone-based triage service. ⋯ The telephone-based nurse triage service appears to be a cost-effective intervention that improves access to medical advice, thereby encouraging appropriate use of medical services. The service is associated with reductions in utilization of hospital ED and physician office services and with high levels of member satisfaction.
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Guidelines for the treatment of community-acquired pneumonia (CAP) have been issued by various institutions. These therapeutic recommendations, culled from available medical literature, can be conflicting and confusing. ⋯ Moreover, costs of care and clinical outcomes can vary significantly with therapeutic approaches. All of these factors point to a critical need for more consistent medical guidelines for treating CAP.
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Comparative Study
Comparing the medical expenses of children with Medicaid and commercial insurance in an HMO.
In recent years, growing numbers of children with Medicaid have been enrolled in managed care plans nationwide. Yet, large, commercial managed care plans are increasingly discontinuing their participation in Medicaid because of low Medicaid payment rates. ⋯ The costs of income-eligible, Medicaid-insured children in this HMO were similar to those of commercially insured children, but the costs for the medically needy and the blind and disabled were substantially higher.