In an area served by a single medical center that operates as both hea
lth maintenance organization (HMO) and fee-for-service clinic, we revi
ewed existing computerized medical records to determine the prevalence
of 11 diseases. Standardized medical care utilization prevalence rati
os, comparing the annual prevalences in the two groups, varied from 1.
38 for rheumatoid arthritis to 0.60 for liver cirrhosis. Unless supple
mented by data from hospitals, physicians, and other sources, HMO data
may result in invalid estimates of the prevalence of chronic disease.