ROANOKE TIMES 
                      Copyright (c) 1996, Roanoke Times

DATE: Thursday, May 30, 1996                 TAG: 9605300088
SECTION: NATIONAL/INTERNATIONAL   PAGE: A-1  EDITION: METRO 
DATELINE: BOSTON
SOURCE: Associated Press 

DOCTORS DID HELP - HOSPITAL ROLLS

MAYBE "PREVENTIVE" MEDICINE really isn't? The doctors who did the study, however, say they wouldn't go that far.

Researchers received a shock after setting out to show that giving sick people better access to family doctors keeps them out of the hospital. Their study found just the opposite: Hospitalizations increased.

``I went in knowing that primary care could help keep these patients out of the hospital. That was my passion. I was exactly wrong,'' said Dr. Eugene Z. Oddone of the Veterans Affairs hospital in Durham, N.C. He and Dr. Morris Weinberger of the VA hospital in Indianapolis offered 1,396 poor, seriously ill veterans ready access to a nurse, a doctor in charge of their case, reminders of appointments and follow-up phone calls.

After six months of this attention, hospitalizations rose by one-third.

The doctors said their study, published in today'sThursday's New England Journal of Medicine, illustrates one of the difficulties of refashioning health care: Even common-sense ideas need to be tested.

For some, the finding raises doubts about an article of faith among doctors - that catching and treating diseases early will make people healthier in the long run. In an accompanying editorial, Dr. H. Gilbert Welch of Dartmouth Medical School said it forces doctors to consider a ``heretical view'':

``Instead of conferring benefit, closer scrutiny of the patients simply led to more medical care and perhaps to harm. We can no longer assume that early intervention is always the right thing to do.''

The VA doctors, however, said Welch's conclusion goes far beyond their results. They noted their patients were already seriously ill, so their ailments were probably not being diagnosed early. The study involved veterans who had been hospitalized because of diabetes, congestive heart failure or chronic obstructive lung disease.

The researchers also denied that the experiment might have been harmful. They said the 25 percent more deaths among the patients getting the extra attention was not statistically meaningful.

They said the extra care obviously resulted in higher medical bills, but they have not calculated how much.

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