Managed care does not lower costs but may result in poorer outcomes for patients with gestational diabetes

J. L. Bienstock, K. J. Blakemore, E. Wang, D. Presser, D. Misra, E. K. Pressman

Research output: Contribution to journalArticle

Abstract

OBJECTIVE: Our purpose was to compare the costs of prenatal care and subsequent maternal and neonatal outcomes in patients with gestational diabetes cared for in an inner-city university hospital house staff clinic versus an inner-city managed care organization. STUDY DESIGN: A retrospective cohort study was conducted. The groups consisted of 115 patients with gestational diabetes who were cared for in a house staff clinic and a demographically similar group of 85 patients cared for in a neighborhood managed care organization. The groups were examined regarding baseline demographics, intensity of prenatal care, maternal and neonatal outcomes, and total cost of the provision of care. RESULTS: There was no difference between groups in the total cost of maternal-infant care. A larger percentage of patients in the house staff group saw the physician frequently. In contrast, patients cared for in the managed care organization underwent more tests of fetal well-being. There was a greater rate of neonatal macrosomia in the managed care organization group compared with the house staff group. CONCLUSIONS: Managed care does not decrease the cost of caring for patients with gestational diabetes but does lead to a greater rate of neonatal macrosomia, which may reflect poorer glucose control.

Original languageEnglish (US)
Pages (from-to)1035-1037
Number of pages3
JournalAmerican journal of obstetrics and gynecology
Volume177
Issue number5
DOIs
StatePublished - Jan 1 1997

Keywords

  • Cost
  • Gestational diabetes
  • Managed care

ASJC Scopus subject areas

  • Obstetrics and Gynecology

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