Managed care does not lower costs but may result in poorer outcomes for patients with gestational diabetes - 11/09/11
Abstract |
Objective: Our purpose was to compare the costs of prenatal care and subsequent maternal and neonatal outcomes in patients with gestational diabetes cared for in an inner-city university hospital house staff clinic versus an inner-city managed care organization. Study Design: A retrospective cohort study was conducted. The groups consisted of 115 patients with gestational diabetes who were cared for in a house staff clinic and a demographically similar group of 85 patients cared for in a neighborhood managed care organization. The groups were examined regarding baseline demographics, intensity of prenatal care, maternal and neonatal outcomes, and total cost of the provision of care. Results: There was no difference between groups in the total cost of maternal-infant care. A larger percentage of patients in the house staff group saw the physician frequently. In contrast, patients cared for in the managed care organization underwent more tests of fetal well-being. There was a greater rate of neonatal macrosomia in the managed care organization group compared with the house staff group. Conclusions: Managed care does not decrease the cost of caring for patients with gestational diabetes but does lead to a greater rate of neonatal macrosomia, which may reflect poorer glucose control.
Le texte complet de cet article est disponible en PDF.Keywords : Managed care, cost, gestational diabetes
Plan
From the Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Johns Hopkins University School of Medicine. |
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Reprint requests: Jessica L. Bienstock, MD, MPH, Division of Maternal-Fetal Medicine, Johns Hopkins Hospital, 600 N. Wolfe St., Baltimore, MD 21287-1228. |
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0002-9378/$5.00 + 0 6/6/84360 |
Vol 177 - N° 5
P. 1035-1037 - novembre 1997 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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