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Chronic illness and plan satisfaction under managed care.

B G Druss1, M Schlesinger, T Thomas

  • 1Department of Psychiatry and Public Health, Yale University, USA.

Health Affairs (Project Hope)
|January 25, 2000
PubMed
Summary
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Individuals with chronic illnesses report greater dissatisfaction with managed care plans, including independent practice associations and prepaid group practices. Their experiences may be negatively impacted compared to healthy individuals.

Area of Science:

  • Health Services Research
  • Public Health
  • Health Economics

Background:

  • Managed care is a prevalent healthcare delivery system.
  • Understanding patient experiences within managed care is crucial for quality assessment.
  • Chronic illness can significantly impact healthcare needs and utilization.

Purpose of the Study:

  • To compare the experiences of individuals with and without chronic illnesses under various managed care models.
  • To identify potential disparities in satisfaction levels based on health status and plan type.

Main Methods:

  • Utilized data from the 1993 Employee Health Care Value Survey (EHCVS).
  • Employed statistical analysis to control for potential confounding factors.
  • Compared patient satisfaction between groups with and without chronic illnesses across different plan types (IPA, PGP, FFS).

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Main Results:

  • Chronic illness was associated with higher odds of dissatisfaction in Independent Practice Association (IPA) and Prepaid Group Practice (PGP) plans.
  • No significant association between chronic illness and dissatisfaction was found under Fee-For-Service (FFS) coverage.
  • Chronic illness appeared to worsen difficulties and reduce benefits for patients in managed care settings.

Conclusions:

  • Individuals with chronic illnesses may face heightened risks and challenges within managed care systems.
  • Health plan performance monitoring should pay special attention to the experiences of chronically ill enrollees.
  • Findings suggest a need for tailored strategies to improve managed care for patients with chronic conditions.