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

Journal Article (Journal Article)

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.

Full Text

Duke Authors

Cited Authors

  • Bienstock, JL; Blakemore, KJ; Wang, E; Presser, D; Misra, D; Pressman, EK

Published Date

  • November 1997

Published In

Volume / Issue

  • 177 / 5

Start / End Page

  • 1035 - 1037

PubMed ID

  • 9396888

International Standard Serial Number (ISSN)

  • 0002-9378

Digital Object Identifier (DOI)

  • 10.1016/s0002-9378(97)70009-7


  • eng

Conference Location

  • United States