Medicare beneficiaries enrolled in a health maintenance organization (HMO) were randomized to a preventive services benefit
package for 2 years or to usual care. At 24- and 48-month followups, the treatment group had completed more advance directives,
participated in more exercise, and consumed less dietary fat than the control group. Unexpectedly, more deaths occurred in
the treatment group. Surviving treatment-group enrollees reported higher satisfaction with health, less decline in self-rated
health status, and fewer depressive symptoms than surviving control participants. Despite these changes, the intervention
did not yield lower cost per quality-adjusted life year in this historically prevention-oriented HMO.
Case Management : Health Expenditures : Health Maintenance Organizations : Program Evaluation : Aged : Data Collection : Evaluation
Studies : Health Status : Medicare/economics/utilization : Questionnaire : Support, U.S. Gov't, non-P.H.S. : United States