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01-09-2007 | Original Paper

Change in health status and mortality as indicators of outcomes: comparison between the Medicare Advantage Program and the Veterans Health Administration

Auteurs: Alfredo J. Selim, Lewis E. Kazis, William Rogers, Shirley X. Qian, James A. Rothendler, Avron Spiro III, Xinhua S. Ren, Donald Miller, Bernardo J. Selim, Benjamin G. Fincke

Gepubliceerd in: Quality of Life Research | Uitgave 7/2007

Abstract

Background

Comparing health outcomes with adequate methodology is central to performance assessments of health care systems. We compared the Medicare Advantage Program (MAP) and the Veterans Health Administration (VHA) with regard to changes in health status and mortality.

Methods

We used the Death-Master-File for vital status and the Short-Form 36 to determine physical (PCS) and mental (MCS) health at baseline and at 2 years. We compared the probability of being alive with the same or better (than would be expected by chance) PCS (or MCS) at 2 years and mortality, while adjusting for case-mix. Given the geographic variations in MAP enrollment, we did a regional sub-analysis.

Results

There were no significant differences in the probability of being alive with the same or better PCS except for the South (VHA 65.8% vs. MAP 62.5%, P = .0014). VHA patients had a slightly higher probability than MAP patients of being alive with the same or better MCS (71.8% vs. 70.1%, P = .002) but no significant regional variations. The hazard ratios for mortality in the MAP were higher than in the VHA across all regions.

Conclusion

With the use of appropriate methodology, we found small differences in 2-year health outcomes that favor the VHA.

vorige artikel Health status, work limitations, and return-to-work trajectories in injured workers with musculoskeletal disorders

volgende artikel Validity of patient-reported health-related quality of life global ratings of change using structural equation modeling

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Titel: Change in health status and mortality as indicators of outcomes: comparison between the Medicare Advantage Program and the Veterans Health Administration
Auteurs: Alfredo J. Selim
Lewis E. Kazis
William Rogers
Shirley X. Qian
James A. Rothendler
Avron Spiro III
Xinhua S. Ren
Donald Miller
Bernardo J. Selim
Benjamin G. Fincke
Publicatiedatum: 01-09-2007
Uitgeverij: Springer Netherlands
Gepubliceerd in: Quality of Life Research / Uitgave 7/2007
Print ISSN: 0962-9343
Elektronisch ISSN: 1573-2649
DOI: https://doi.org/10.1007/s11136-007-9216-2

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Abstract

Background

Methods

Results

Conclusion

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