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Updated: Aug 6, 2026
11:35
The Multiple Sclerosis Performance Test (MSPT): An iPad-Based Disability Assessment Tool
Published on: June 30, 2014
Management of multiple sclerosis across managed care and fee-for-service systems
B G Vickrey1, D Shatin, S M Wolf
1Department of Neurology, University of California at Los Angeles, 90095-1769, USA. bvickrey@ucla.edu
Neurology
|November 23, 2000
Summary
Care for multiple sclerosis (MS) patients varied across health systems. Fee-for-service (FFS) showed more symptom management referrals, but all systems need improvement in symptom assessment and patient information access.
Area of Science:
- Neurology
- Health Services Research
- Comparative Effectiveness
Background:
- Multiple sclerosis (MS) care delivery differs across healthcare systems.
- Understanding these differences is crucial for optimizing patient outcomes.
Purpose of the Study:
- To compare the quality of care for adults with MS between managed care (Health Maintenance Organization [HMO], Independent Practice Association [IPA]) and fee-for-service (FFS) systems.
- To identify variations in symptom management, treatment access, and patient information needs.
Main Methods:
- Survey of 930 adults with MS across HMO, IPA, and FFS settings.
- Data collected on demographics, clinical characteristics, symptom management, disease-modifying agent use, and information needs.
- Statistical adjustments for comorbidity, disease severity, and type.
Main Results:
- Few differences in symptom management, with a trend toward more FFS referrals.
- No difference in access to disease-modifying agents, but varied patient perceptions.
- FFS and IPA systems assessed general health more than HMO; all systems require improvement.
- Substantial unmet patient information needs across all systems, particularly in FFS and HMO.
Conclusions:
- Care for MS patients requires improvement in symptom assessment and patient information delivery.
- Further research is needed to evaluate the impact of service delivery variations on outcomes.
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