This observational study evaluates how organizational and financial arrangements in Medicare managed care and fee-for-service (FFS) settings affect the use and content of primary and referral care. The proposed study adds a comprehensive analytic phase and valuable longitudinal and chart abstraction components to an already funded cross-sectional study.
The specific aims of the overall investigation are:
Specific Aim 1 : To compare use of services relative to accepted clinical standards for persons with type 2 diabetes in Medicare managed care relative to FFS Medicare. Integral to this specific aim is distinguishing variation in case-mix from system performance differences.
Specific Aim 2 : To determine whether race, ethnicity, or socioeconomic status is independently associated with functional status, use of primary and referral care, and the quality of the process of care in managed care and FFS settings.
Specific Aim 3 : To evaluate Specific Aims 1 and 2 relative to within managed care arrangements, such as generalist- specialist risk-sharing arrangements. This study should deepen the understanding of the role of financial and organizational arrangements on access to and quality of care provided to Medicare beneficiaries with diabetes.

Agency
National Institute of Health (NIH)
Institute
Agency for Healthcare Research and Quality (AHRQ)
Type
Postdoctoral Individual National Research Service Award (F32)
Project #
1F32HS000132-01
Application #
2767994
Study Section
Special Emphasis Panel (ZHS1-HSRD-A (01))
Program Officer
Rudzinski, Karen
Project Start
1998-09-01
Project End
Budget Start
1998-09-30
Budget End
1999-09-29
Support Year
1
Fiscal Year
1998
Total Cost
Indirect Cost
Name
University of California Los Angeles
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
119132785
City
Los Angeles
State
CA
Country
United States
Zip Code
90095