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The Elderly and Poor in the Medical Outcomes Study-Reply FREE

John E. Ware, Jr, PhD; Martha S. Bayliss, MSc; William H. Rogers, PhD; Mark Kosinski, MA; Alvin R. Tarlov, MD
JAMA. 1996;276(24):1953-1953. doi:10.1001/jama.1996.03540240031020
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In Reply.  —We agree with the need for better understanding quasi-experimental (observational) methods for monitoring health care. Methods like those used in the MOS1 will provide most of the information about changes in the utilization of health care services and health outcomes following health care reform.We disagree with Drs Barrett and Juhn that MOS conclusions were based on "inconsistent results" and "novel" contrasts. Contrasts were planned in advance,1 and results were consistent.2 As documented in Tables 4 and 5 of our article2 for analyses of both average changes and categories of change, we could reject the hypothesis that the differences between FFS and HMO systems in physical health were the same across elderly and nonelderly and across poor and nonpoor subgroups. The change score cut points were based on other studies3,4 and were not subject to gaming. Including elderly patients who died in the worse category

REFERENCES

Tarlov AR, Ware JE, Greenfield S, Nelson EC, Perrin E, Zubkoff M.  The Medical Outcomes Study: an application of methods for monitoring the results of medical care . JAMA . 1989;;262:925-930.
Ware JE Jr, Bayliss MS, Rogers WH, Kosinski M, Tarlov AR.  Differences in 4-year health outcomes for elderly and poor, chronically ill patients treated in HMO and fee-for-service systems: results from the Medical Outcomes Study . JAMA . 1996;;276:1039-1047.
Ware JE, Kosinski M, Bayliss MS, McHorney CA, Rogers WH, Raczek A.  Comparison of methods for scoring and statistical analysis of SF-36 health profiles and summary measures: summary of results from the Medical Outcomes Study . Med Care . 1995;;33( (suppl 4) ):AS264-AS279.
Ware JE, Kosinski M, Keller SK. SF-36 Physical and Mental Health Summary Scales: A User's Manual . Boston, Mass: The Health Institute, New England Medical Center; 1994;.

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Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

Tarlov AR, Ware JE, Greenfield S, Nelson EC, Perrin E, Zubkoff M.  The Medical Outcomes Study: an application of methods for monitoring the results of medical care . JAMA . 1989;;262:925-930.
Ware JE Jr, Bayliss MS, Rogers WH, Kosinski M, Tarlov AR.  Differences in 4-year health outcomes for elderly and poor, chronically ill patients treated in HMO and fee-for-service systems: results from the Medical Outcomes Study . JAMA . 1996;;276:1039-1047.
Ware JE, Kosinski M, Bayliss MS, McHorney CA, Rogers WH, Raczek A.  Comparison of methods for scoring and statistical analysis of SF-36 health profiles and summary measures: summary of results from the Medical Outcomes Study . Med Care . 1995;;33( (suppl 4) ):AS264-AS279.
Ware JE, Kosinski M, Keller SK. SF-36 Physical and Mental Health Summary Scales: A User's Manual . Boston, Mass: The Health Institute, New England Medical Center; 1994;.
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To understand the clinical management of acute heart failure syndromes.
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