BACKGROUND: The growth of managed health care in the United States has been accompanied by controls on access to specialty physician services. We examined the relationship of physician specialty to treatment and outcomes of @entity1 with @entity565 in managed care plans. METHODS: We conducted a mail survey of adult @entity565 @entity1 who were enrolled in 12 managed care organizations and had at least 2 contacts for @entity565 (International Classification of Diseases, Ninth Revision, Clinical Modification code 493.x) during the previous 24 months; we also surveyed their treating physicians. This report concerns 1954 @entity1 and their 1078 corresponding physicians. Treatment indicators included use of corticosteroid inhalers, use of peak flow meters, @entity566 evaluation, discussion of triggers, and @entity1 self-management knowledge. Outcome measures included canceled activities, hospitalization or emergency department visits, @entity565 , workdays lost, @entity565 symptoms, physical and mental health, overall satisfaction with @entity565 care, and satisfaction with communication with physicians and nurses. RESULTS: Significant differences were noted for @entity1 of specialists and experienced generalists compared with those of generalist physicians. Peak flow meter possession was reported by 41.9% of @entity1 of generalists, 51.7% of @entity1 of experienced generalists, and 53.8% of @entity1 of pulmonologists or allergists. Compared with @entity1 of generalists, outcomes were significantly better for @entity1 of allergists with regard to canceled activities, hospitalizations and emergency department visits for @entity565 , quality of care ratings, and physical functioning. @entity1 of pulmonologists were more likely to rate improvement in symptoms as very good or excellent. CONCLUSIONS: In a managed health care setting, physicians' specialty training and self-reported expertise in treating @entity565 were related to better @entity1 -reported care and outcomes.

Quality of care and outcomes of adults with XXXX treated by specialists and generalists in managed care.

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients', 'patient'] @entity565 :: ('MESH:D001249', 'Disease') :: ['asthma attacks', 'asthma'] @entity566 :: ('MESH:D006967', 'Disease') :: ['allergy']
@entity565 :: (MESH:D001249,Disease) :: ['asthma']
