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dc.contributor.authorGrembowski, Daviden_US
dc.contributor.authorPaschane, Daviden_US
dc.contributor.authorDiehr, Paulaen_US
dc.contributor.authorKaton, Wayneen_US
dc.contributor.authorMartin, Dianeen_US
dc.contributor.authorPatrick, Donald L.en_US
dc.date.accessioned2010-04-21T15:52:44Z
dc.date.available2010-04-21T15:52:44Z
dc.date.issued2007en_US
dc.identifier.citationGrembowski D, Paschane D, Diehr P, et al. Managed care and patient ratings of the quality of specialty care among patients with pain or depressive symptoms. BMC Health Services Research. 2007;7(1):22.en_US
dc.identifier.other10.1186/1472-6963-7-22en_US
dc.identifier.urihttp://www.biomedcentral.com/1472-6963/7/22en_US
dc.identifier.urihttp://hdl.handle.net/1773/15748
dc.description.abstractBackground: Managed care efforts to regulate access to specialists and reduce costs may lower quality of care. Few studies have examined whether managed care is associated with patient perceptions of the quality of care provided by physician and non-physician specialists. Aim is to determine whether associations exist between managed care controls and patient ratings of the quality of specialty care among primary care patients with pain and depressive symptoms who received specialty care for those conditions. Methods: A prospective cohort study design was conducted in the offices of 261 primary physicians in private practice in Seattle in 1997. Patients (N = 17,187) were screened in waiting rooms, yielding a sample of 1,514 patients with pain only, 575 patients with depressive symptoms only, and 761 patients with pain and depressive symptoms. Patients (n = 1,995) completed a 6-month follow-up survey. Of these, 691 patients received specialty care for pain, and 356 patients saw mental health specialists. For each patient, managed care was measured by the intensity of managed care controls in the patient's health plan and primary care office. Quality of specialty care at follow-up was measured by patient rating of care provided by the specialists. Outcomes were pain interference and bothersomeness, Symptom Checklist for Depression, and restricted activity days. Results: The intensity of managed care controls in health plans and primary care offices was generally not associated with patient ratings of the quality of specialty care. However, pain patients in more-managed primary care offices had lower ratings of the quality of specialty care from physician specialists and ancillary providers. Conclusion: For primary care patients with pain or depressive symptoms and who see specialists, managed care controls may influence ratings of specialty care for patients with pain but not patients with depressive symptoms.en_US
dc.description.sponsorshipAgency for Healthcare Research and Quality (AHRQ) Grant No. HS06833 and No. HS11712.en_US
dc.language.isoen_USen_US
dc.titleManaged care and patient ratings of the quality of specialty care among patients with pain or depressive symptomsen_US
dc.typeArticleen_US


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