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BACKGROUND Little information exists about the consequences of limits on prescription-drug benefits for Medicare beneficiaries. METHODS We compared the clinical and economic outcomes in 2003 among 157,275 Medicare+Choice beneficiaries whose annual drug benefits were capped at 1,000 dollars and 41,904 beneficiaries whose drug benefits were unlimited(More)
BACKGROUND Use of the emergency department for nonemergency care is frequent and costly. We studied the effect of a copayment on emergency department use in a group-model health maintenance organization (HMO). METHODS We examined the use of the emergency department in 1992 and 1993 by 30,276 subjects who ranged in age from 1 to 63 years at the start of(More)
OBJECTIVE To evaluate if midlife cardiovascular risk factors are associated with risk of late-life dementia in a large, diverse cohort. METHOD The authors conducted a retrospective cohort study of 8,845 participants of a health maintenance organization who underwent health evaluations from 1964 to 1973 when they were between the ages of 40 and 44. Midlife(More)
OBJECTIVE Some preclinical in vivo studies and limited human data suggest a possible increased risk of bladder cancer with pioglitazone therapy. This is an interim report of an ongoing cohort study examining the association between pioglitazone therapy and the risk of bladder cancer in patients with diabetes. RESEARCH DESIGN AND METHODS This study(More)
PURPOSE We sought to evaluate the effectiveness of self-monitoring blood glucose levels to improve glycemic control. SUBJECTS AND METHODS A cohort design was used to assess the relation between self-monitoring frequency (1996 average daily glucometer strip utilization) and the first glycosylated hemoglobin (HbA1c) level measured in 1997. The study sample(More)
BACKGROUND Glycemic control is associated with microvascular events, but its effect on the risk of heart failure is not well understood. We examined the association between hemoglobin (Hb) A(Ic) and the risk of heart failure hospitalization and/or death in a population-based sample of adult patients with diabetes and assessed whether this association(More)
A synthesis of findings from the TRIAD Study THE TRIAD STUDY GROUP* H ealth care systems have played a central role in the public health response to the growing problem of diabetes (1–2) and its complications. During the 1990s, managed care organizations (MCOs) began seeking system-level approaches to improve diabetes outcomes and control costs in covered(More)
Although commonly thought to be an effective method of screening for prostatic cancer, digital rectal examinations have yet to be shown by controlled study to help prevent advanced forms of this disease. 139 men with metastatic (stage D) prostatic cancer (cases) were compared with an equal number of matched men free of this condition (controls), with(More)
OBJECTIVE To evaluate the patterns of e-Health use over a four-year period and the characteristics of users. DESIGN Longitudinal, population-based study (1999-2002) of members of a prepaid integrated delivery system. Available e-Health services included ordering prescription drug refills, scheduling appointments, and asking medical questions. (More)
OBJECTIVE Cardiovascular disease (CVD) mortality has decreased in men but not in women with diabetes. We investigated whether sex differences in control and treatment of CVD risk factors might underlie this disparity. RESEARCH DESIGN AND METHODS We performed cross-sectional analyses from a cohort of patients with diabetes sampled from 10 U.S. managed care(More)