Effect of utilization review in a fee-for-service health insurance plan.

Background: Although utilization review is widely used to control health care costs, its effect on patterns of health care is uncertain.

Methods: In 1989, New York City and its unions temporarily replaced actual utilization review with sham review for half the participants in the city's fee-for-service health insurance plan. We compared the health services provided to 3702 enrollees whose requests were subjected to utilization review (the review group) with the services provided to 3743 enrollees whose requests received sham review and were automatically approved for insurance coverage (the nonreview group).

Myofascial face pain: seasonal variability in pain intensity and demoralization.

Seasonal variability has been detected in a variety of illnesses. The purpose of this study is to examine seasonal variability in pain intensity, demoralization and range of mandibular motion among patients suffering from myofascial face pain. Pain and demoralization for cases (n = 140) and demoralization for controls (n = 133) were measured in each of 10 monthly interviews.

The impact of human immunodeficiency virus serostatus on reproductive decisions of women.

Each year in the United States, several thousand women infected with the human immunodeficiency virus (HIV) become pregnant. The scope of the pediatric HIV epidemic will be determined by the reproductive decisions of these women. Although initial studies have not documented an effect of serostatus on reproductive choice, these studies have been limited to single-risk groups (eg, drug users) and have had small numbers of participants.