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National Information Center on Health Services Research and Health Care Technology (NICHSR)

HSRProj (Health Services Research Projects in Progress)

Information about ongoing health services research and public health projects


Medicaid managed care and access to health services.
(Archived Project)
Investigator (PI): Gibson, PJ
Performing Organization (PO): (Current): University of Washington, School of Public Health
Supporting Agency (SA): Agency for Healthcare Research and Quality (AHRQ)
Initial Year: 1994
Final Year: 1996
Record Source/Award ID: CRISP/R03HS008419
Award Type: Grant
Abstract: Objective: To determine how access to medical services for Medicaid clients is affected by the change from a fee-for-service system to a capitated, gatekeeper system. Health status and satisfaction with care will also be assessed. Significance: Across the United States, managed care systems are replacing fee-for-service systems for Medicaid populations. The effect of this switch on access is unclear. Previous studies have not measured access both before and after the switch. The results may help guide future health reform measures, and may lead to improvements in the Medicaid system. Design, Setting, and Sample: Quasi-experimental, using a pre- versus postchange comparison with a control group. A self-administered questionnaire will be mailed to 1500 AFDC-Medicaid client-families and 750 Basic Health Plan client-families in Pierce County, Washington, two months before the AFDC-Medicaid clients are switched to managed care. The subjects will be re-surveyed ten months after the switch to managed care. In the follow-up survey, a new random sample from each program will be included to make up for loss to follow-up. Main Outcome Measures: Individual and group changes in four dimensions of access, as measured by responses to a battery of questionnaire items. Any changes in specific components of access will also be described.
MeSH Terms:
  • Aid to Families with Dependent Children
  • * Health Services Accessibility
  • Humans
  • Managed Care Programs
  • Medicaid
  • Outcome Assessment, Health Care
  • Random Allocation
  • Referral and Consultation
  • Washington
Keywords:
  • health behavior
  • health care cost financing
  • health care professional practice
  • health care service availability
  • health care service planning
  • health care service utilization
  • human subject
  • longitudinal human study
  • low income
  • patient care management
  • patient care planning
  • patient professional relations
  • questionnaire
  • research support, U.S. Gov't, P.H.S.
  • satisfaction
Country: United States
State: Washington
Zip Code: 98109
UI: 95401450
Project Status: Archived