HMO data systems in population studies of access to care
1Graduate School of Health Science, New York Medical College, Valhalla 10595, USA.
Objectives:
A review of the current status of HMO data sets and their applicability to population studies of access to care.
Data Sources:
Publications and reports based on research among different models of HMOs; reviews of HMO quality of care by national organizations; and HMO industry profiles.
Study Design:
Design was a literature review of the content of HMO data sets: completeness of reporting, processing, and reporting.
Data Collection:
Publications and publicly available reports were reviewed.
Principal Findings:
Most HMOs are able to aggregate the number of services provided but demonstrate little ability to provide patient profiles. While their content is limited, HMO data sets are significant improvements over indemnity plan data, and where available, their accuracy in measuring health services utilization is superior to that of surveys. There are important differences among HMO delivery systems in their ability to provide useful data for population studies.
Conclusions:
A valuable resource, HMO data are limited by their content and the relative inaccessibility to IPAC-HMO information. This could be improved through new financial and technical support to HMOs interested in research.
More Related Videos
Related Concept Videos
01:30Health Information Technology and Healthcare Information System
Health Information Technology, commonly called HIT, integrates advanced information systems and technology in healthcare settings. Its primary functions include:
01:29Documentation in Long-Term and Home Healthcare Setting
Long-Term Care Facilities
01:26Methods Of Healthcare Delivery System
Managed Care System:
The managed care system is designed to control the cost while maintaining the quality of care. The patient's care from admission to discharge is planned by the primary care provider or the case manager, also known as the gatekeeper. In a managed care system, the number of care providers is...
01:15Methods of Documentation VI: Case Management Model
For example, a patient with a chronic...
01:20Integrated Healthcare System
01:26Methods of Documentation II: POMR