DuGoff Eva, Tabak Ruth, Diduch Tyler, Garth Viviane
Berkeley Research Group, 1800 M St NW, Second Fl, Washington, DC 20036. Email:
Am J Manag Care. 2021 Sep;27(9):395-400. doi: 10.37765/ajmc.2021.88641.
To compare Medicare Advantage (MA) and traditional Medicare (TM) performance on quality, health, and cost outcomes in peer-reviewed literature published since 2010.
Systematic review of peer-reviewed papers published between January 1, 2010, and May 1, 2020.
To identify relevant research papers, we searched MEDLINE, EBSCO, and ProQuest. We excluded any studies that did not meet several inclusion criteria. Titles, abstracts, and full-text articles were independently reviewed by 1 author and several trained research assistants. Disagreements were resolved through discussion. We also reviewed the bibliographies of included studies and consulted subject matter experts to identify additional papers.For each eligible study, we extracted the first author, year published, study design, data sources, study years, sample sizes, relevant measures, and study quality. To ensure consistent and complete data extraction, each article was reviewed by 2 reviewers. Study quality was assessed using a modified Newcastle-Ottawa Scale.
Thirty-five studies including 208 analyses were included. All included studies were observational. Two-thirds of studies were of high methodological quality for observational studies, and 49% addressed selection bias. Analyses compared quality of care (41%), health outcomes (44%), and spending (15%). Overall, 65% of analyses found a statistically significant relationship: 52% favored MA and 13% favored TM.
More than half of recent analyses comparing MA and TM find that MA delivers significantly better quality of care, better health outcomes, and lower costs compared with TM.
比较2010年以来同行评审文献中医疗保险优势（MA）和传统医疗保险（TM）在质量、健康和成本结果方面的表现。
对2010年1月1日至2020年5月1日发表的同行评审论文进行系统综述。
为识别相关研究论文，我们检索了MEDLINE、EBSCO和ProQuest。我们排除了任何不符合多项纳入标准的研究。标题、摘要和全文文章由1位作者和几名经过培训的研究助理独立评审。分歧通过讨论解决。我们还查阅了纳入研究的参考文献，并咨询了主题专家以识别其他论文。对于每项符合条件的研究，我们提取了第一作者、发表年份、研究设计、数据来源、研究年份、样本量、相关指标和研究质量。为确保数据提取的一致性和完整性，每篇文章由2名评审员进行评审。研究质量使用改良的纽卡斯尔-渥太华量表进行评估。
纳入了35项研究，包括208项分析。所有纳入研究均为观察性研究。三分之二的研究在观察性研究方面具有较高的方法学质量，49%的研究涉及选择偏倚。分析比较了医疗质量（41%）、健康结果（44%）和支出（15%）。总体而言，65%的分析发现存在统计学显著关系：52%支持MA，13%支持TM。
最近比较MA和TM的分析中，超过一半发现与TM相比，MA提供了显著更好的医疗质量、更好的健康结果和更低的成本。
