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ISSUES IN SCIENCE AND TECHNOLOGY 1991年第4期7卷 56-62页

作者： COYE, MJ JOHNS HOPKINS UNIV SCH PUBL HLTH BALTIMORE MD 21218 USA

Innovative state programs and possibilities for an effective national program. Uncompensated-care systems, Medicaid expansion, state subsidies for private insurance, and employer-mandated health insurance.

关键词：保健福利计划雇员/组织和管理卫生服务研究保险住院/组织和管理 Medicaid/组织和管理医疗费用无力承担/经济学贫困社会问题州卫生计划/经济学美国美国卫生和人类服务部

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Heart failure disease management in an indigent population

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AMERICAN HEART JOURNAL 2001年第2期141卷 254-258页

作者： O'Connell, AM Crawford, MH Abrams, J Univ New Mexico Sch Med Albuquerque NM 87131 USA

Background Multidisciplinary disease management programs (MDMP) have demonstrated reduced hospitalizations in motivated pretransplant heart failure populations, but little is known about their effectiveness in largely indigent patients who are not transplant candidates. Methods and Results We studied 35 patients with heart failure with left ventricular election fraction (EF) less than or equal to 45% enrolled in an MDMP who were either indigent or funded by Medicaid/Medicare. This nonrandomized sample consisted of 14 patients identified because they had hospital readmission rates of greater than or equal to2 per year (group A) and 21 patients referred by their primary care physicians because they were difficult to manege (group B). Group A patients were New York Heart Association (NYHA) class III or IV, aged 25 to 87 years (mean 57 +/- 17 SD) and had an EF of 15% to 45% (29% +/- 11%). Group B patients were NYHA class II or III, aged 35 to 86 (57 +/- 16) years and had an EF of 20% to 45% (28% +/- 10%): Data were compared for the year before enrollment in the MDMP and the year afterward. In group A hospital admissions decreased from 33 to 3, a 91% reduction, and NYHA class improved to class II-III (P < .001). In group B hospital admissions decreased from 9 to 0, and NYHA class improved to class I-II (P < .001). When hospital and clinic charges were assessed for both groups, the net savings were $162,000 per year or $4600 per patient. Conclusions A multidisciplinary heart failure program can improve functional status and reduce hospitalization and net costs compared with conventional care in indigent non-transplant candidate patients.

关键词：成本及成本分析医院费用住院/经济学住院/统计学和数值数据医疗费用无力承担/经济学未参加医疗保险者/统计学和数值数据回顾性研究美国成年人老年人老年人 80以上女(雌)性人类男(雄)性中年人

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Who bears the burden of uncompensated hospital care?

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Journal of health & social policy 1990年第1期2卷 9-20页

作者： Tuckman, H.P. Chang, C.F. Memphis State University TN 38152.

This paper considers the question of who bears the burden of uncompensated hospital care. The thesis is that the hospital that provides the services received by indigent patients may not be the one that eventually bears the financial burden. The various sources of funds available for the payment of indigent care are identified and the incidence of financial burden discussed. The paper ends by addressing several considerations that should be taken into account in evaluating how fairly the indigent care burden is distributed.

关键词：费用分配/经济学财务管理医院/方法筹资政府/方法筹资组织/方法医疗费用无力承担/经济学美国人类

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Going off the dole: A prudential and ethical critique of the healthfare state

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Health Care Analysis 1993年第1期1卷 33-38页

作者： Spicker, Stuart F. Center for Ethics Medicine and Public Issues Baylor College of Medicine Houston Texas United States

The present 'healthfare' state in the United States in neither practically nor morally justified. The nation currently fails to provide adequate access to health care for tens of millions of uninsured citizens. To suggest that the United States' half-million physicians should provide their care as charity is an inadequate solution. The transfer of assets from the 'haves' to the 'have-nots' through taxation in a 'healthfare state' undermines human compassion, and fails to respect minimal moral requirements. However, alternative strategies are possible. During the next 20 years health care could come to be financed on the basis of sound quasi-libertarian moral and prudential principles. In the interim deliberate political action is required to achieve novel health policy, available and affordable job and career training, and universal employment. It is possible to achieve universal access to adequate health care while sustaining individual choice, and at the same time to reduce or virtually eliminate taxpayersubsidised health care. This approach would, in time, eliminate the healthfare state and eventually encourage and even require citizens to go off the healthfare dole. © 1993 John Wiley & Sons, Ltd.

关键词：资本主义慈善机构/经济学教育就业联邦政府政府调控卫生保健改革/经济学卫生保健改革/标准卫生服务易得程度/经济学保险健康/经济学医疗费用无力承担/经济学政策制订贫困社会正义社会福利/经济学税款美国

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Indigent health care: the increasing contribution of AIDS to the health care budget deficit.

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Journal of health & social policy 1990年第1期2卷 47-53页

作者： Palte, S.B. Lancaster, D.J. University of Tennessee Center for the Health Sciences Memphis 38103.

With the number of AIDS cases in the United States exceeding 100,000 and rising, it is becoming more of a financial burden to take care of this population. The Regional Medical Center at Memphis, like most hospitals providing indigent care, sustains annually a large deficit for both outpatient and inpatient care of AIDS patients. With the establishment of a dedicated AIDS clinic, it is hoped to maximize outpatient care and the utilization of available financial resources. Implementation of this model may help obviate the financial disaster that is impending for the already overburdened public hospitals and their patients.

关键词：获得性免疫缺陷综合征/经济学获得性免疫缺陷综合征/流行病学医院病床数 300至499张医院公立/经济学医院大学/组织和管理医疗费用无力承担/经济学模型理论门诊部医院/经济学门诊部医院/利用田纳西/流行病学人类

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HIV infection and AIDS: another layer to consider in addressing indigent health care in the United States.

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Journal of health & social policy 1990年第1期2卷 35-45页

作者： Walton, R.A. School of Allied Health Professions State University of New York Stony Brook 11794.

This paper will present the current status of the epidemic of HIV infection and AIDS and show relationships to indigent health care. Statistics of disproportionate race and ethnic minorities affected with poverty and HIV infection will be discussed. Projections of who will be affected and estimates of the impact will be included. Community planning in regard to legislative, service, and educational agenda will be suggested.

关键词：获得性免疫缺陷综合征/经济学获得性免疫缺陷综合征/流行病学 HIV感染/经济学 HIV感染/流行病学卫生政策/经济学卫生政策/立法和法学医疗费用无力承担/经济学少数民族/统计学和数值数据美国/流行病学女(雌)性人类

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Health care coverage-resolving the uninsured employee dilemma: Government mandates or incentives?

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Health Marketing Quarterly 1990年第1-2期8卷 17-25页

作者： Brinkman, Louise Hatfield Mc Dermott, Dennis R. School of Business Virginia Commonwealth University United States

No abstract available for this article.

关键词：行政管理人员/统计学和数值数据评价研究保健福利计划雇员/立法和法学工业/统计学和数值数据医疗费用无力承担/经济学问卷调查弗吉尼亚

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Indigent health care plan for Tennessee.

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Journal of health & social policy 1990年第1期2卷 71-77页

作者： Light, R.T. Tennessee Department of Health & Environment Nashville 37219.

The author describes the development of an Indigent Health Care Program for the State of Tennessee from the campaign pledge of the Governor, through the development of an Indigent Care Cabinet Council, to the development and enactment of appropriate legislation required to implement this program. The program deals with availability of health care services, accessibility to health care services and funding mechanisms. The backbone of the program is the involvement of the local community and the coordinating and networking of the existing private, community and state health care providers.

关键词：社区卫生中心/经济学社区卫生中心/立法和法学卫生服务易得程度/经济学卫生服务易得程度/立法和法学 Medicaid/立法和法学医疗补助/立法和法学医疗费用无力承担/经济学医疗费用无力承担/立法和法学缺医地区医师/经济学医师/立法和法学医师/供应和分配规划制订/方法公共卫生管理州卫生计划/立法和法学田纳西美国人类

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Uncompensated hospital care.

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Medical care review 1992年第3期49卷 265-330页

作者： Duncan, R.P. Center for Health Policy Research University of Florida Gainesville 32610. United States

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Primary prevention with the poor: structural conflicts between the health and welfare systems.

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Journal of health & social policy 1989年第1期1卷 99-103页

作者： Nolan, P.A. Pima County Health Department Tucson AZ United States

Arizona has developed a Medicaid program under the waiver provisions of Title XIX of the Social Security Act. This paper examines how well a managed care system for Medicaid recipients works in delivering prevention s... 详细信息

关键词：亚利桑那健康维护组织/组织和管理 Medicaid/组织和管理医疗费用无力承担/经济学贫困一级预防方案评价美国

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