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Workers' compensation in the United States and the role of the primary care physician

PRIMARY CARE 2000年第4期27卷 831-+页

作者： Pye, H Orris, P Cook Cty Hosp Div Occupat Med Chicago IL 60612 USA Univ Illinois Sch Publ Hlth Great Lakes Ctr Occupat & Environm Safety & Hlth Chicago IL USA

The workers' compensation system was designed as a no-fault system in the early years of the last century. The system is organized on a state level. There are three differing models in current use: the single public fund, the single private fund, and an open market. States range as well in the amount of choice available to the injured workers in their selection of health care providers. In each state though, the physician plays an integral role in ensuring that the injured worker obtains adequate medical care in a prompt and efficient manner. The physician's function is either as treating physician, or as one who provides an independent medical evaluation for either the employee's lawyer, the employer, the insurer or their counsel or the state. Many obvious improvements in the system have not been made because political agreement on the state level is often lacking.

关键词：病例管理/组织和管理合格鉴定司法鉴定家庭医学/组织和管理筹资政府/组织和管理卫生服务使用研究密执安模型组织管理职业医学/组织和管理医师的作用政治初级卫生保健/组织和管理私营部门/组织和管理美国华盛顿工人补偿金/组织和管理人类

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Effects of case-load size on the process of care of patients with severe psychotic illness - Report from the UK700 trial

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BRITISH JOURNAL OF PSYCHIATRY 2000年第5期177卷 427-433页

作者： Burns, T Fiander, M Kent, A Ukoumunne, OC Byford, S Fahy, T Kumar, KR St George Hosp Sch Med Dept Gen Psychiat London SW17 0RE England Hammersmith Hosp Imperial Coll Sch Med Dept Med Stat & Evaluat London England Univ York Ctr Hlth Econ York YO1 5DD N Yorkshire England Maudsley Hosp London SE5 8AZ England St Charles Hosp London W10 6DZ England

Background Studies of intensive case management (ICM) for patients with psychotic illnesses have produced conflicting results in terms of outcome. Negative results have sometimes been attributed to a failure to deliver differing patterns of care. Aims To test whether the actual care delivered in a randomised clinical trial of ICM v. standard case management (the UK700 trial) differed significantly. Method Data on 545 patients' care were collected over 2 years. All patient contacts and all other patient-centred interventions (e.g. telephone calls, carer contacts) of over 15 minutes were prospectively recorded. Rates and distributions of these interventions were compared. Results Contact frequency was more than doubled in the ICM group. There were proportionately more failed contacts and carer contacts but-there was no difference in the average length of individual contacts or the proportion of contacts in the patients' homes. Conclusions The failure to demonstrate outcome differences in the UK700 study is not due to a failure to vary the treatment process. UK standard care con-rains many of the characteristics of assertive outreach services and differences in outcome may require that greater attention be paid to delivering evidence-based interventions;Declaration of interest None.

关键词：日常生活活动医疗护理提供者病例管理/组织和管理社区精神病学/组织和管理卫生保健提供/组织和管理英格兰医生病人关系前瞻性研究精神病/治疗工作负荷量青少年成年人老年人人类中年人

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Are small case-loads beautiful in severe mental illness?

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BRITISH JOURNAL OF PSYCHIATRY 2000年第5期177卷 386-387页

作者： Tyrer, P Univ London Imperial Coll Sci Technol & Med Sch Med Dept Publ Mental Hlth Div Neurosci & Psychol MedPaterson Ctr London W2 1PD England

[...]those in the intensive management service also received a brief course of training in the Boulder Community Support System (CSS) model of care; this shows similarities with assertive community treatment (ACT) practised elsewhere in the USA (Stein & Santos, 1998, p. 33). The main question the findings pose is why the greater frequency of contact in ICM was not translated into any clinical improvement with regard to either the primary outcome (duration of in-patient psychiatric treatment during the study) or a range of secondary outcomes, including the specific one that improvement with ICM might be more effective in those of African-Caribbean ethnicity (UK700 Group, 1999a ). Assertive community treatment comprises six essential features: case-loads of no fewer than 8 and no more than 12 per keyworker, an integrated team structure with at least three professional disciplines, no more than 20% of staff part-time, 24-hour availability, team autonomy and (an important consideration) part-time psychiatrist input only (Stein & Santos, 1998, pp. 64-65). The presence of 24-hour cover is also not as important in the UK as in the USA. Because there is often no real health cover available for these patients in the USA it is easy to see why it was necessary to set up a telephone contact system.

关键词：病例管理/组织和管理社区精神病学/组织和管理循证医学精神障碍/治疗模型组织管理工作负荷量人类

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Managing sexually transmitted diseases in the tropics: is a laboratory really needed?

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TROPICAL DOCTOR 2000年第1期30卷 42-46页

作者： Mayaud, P Mabey, DCW Univ London London Sch Hyg & Trop Med Dept Infect & Trop Dis Clin Res Unit London WC1E 7HT England

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Iowa Medicaid to begin paying pharmacists in case management project

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AMERICAN JOURNAL OF HEALTH-SYSTEM PHARMACY 2000年第18期57卷 1650-+页

作者： [Anonymous]

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Early reports on Iowa pharmaceutical case management seem encouraging

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AMERICAN JOURNAL OF HEALTH-SYSTEM PHARMACY 2001年第7期58卷 560-+页

作者： Landis, NT

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The impact of case management on utilization of community support services in a rural state

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ADMINISTRATION AND POLICY IN MENTAL HEALTH 1998年第2期26卷 125-135页

作者： Rohland, BM Rohrer, JE Etsey, YK Univ Iowa Coll Med Psychiat Res MEB Iowa City IA 52242 USA

The authors report on a study testing the hypothesis that persons with serious mental illness (SMI) would report more utilization of community support services if they had a case manager. Individuals with SMI were asked to complete a survey reporting their use of 10 community support services and case management Having a case manager was not associated with increased utilization of any support service or case management by persons with serious mental illness in this rural state.

关键词：病例管理/组织和管理社区精神卫生服务/利用卫生保健调查衣阿华精神障碍/心理学精神障碍/治疗方案评价问卷调查乡村卫生服务/利用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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Evaluation of case management needs of clients from non-English speaking backgrounds by key workers in a public agency.

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The Australian and New Zealand journal of mental health nursing 1999年第4期8卷 176-186页

作者： Shackleton, M.G. Julia Farr Services Adelaide Australia

Twenty key workers in a government agency evaluated the effectiveness of their interventions with culturally diverse clients. The sample comprised 73 clients, from 18 language groups. Forty per cent reported not having enough to do during the day and seventy-three per cent were visited regularly by their key workers. Ninety-two per cent were social security recipients. Though eighty-five per cent of key worker respondents perceived that the major needs of their clients were being met, twenty-one per cent felt they had insufficient contact with clients. The cultural appropriateness of interventions and client's accessibility to services were not confirmed in anecdotal comments.

关键词：医务工作者的态度病例管理/组织和管理信息交流障碍社区精神卫生服务/组织和管理文化多样性人种群/统计学和数值数据需求估价/组织和管理公共卫生工作问卷调查南澳大利亚青少年成年人老年人女(雌)性人类男(雄)性中年人

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Implementation of an inpatient case management program in rural hospitals

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JOURNAL OF RURAL HEALTH 1996年第1期12卷 54-66页

作者： Bertram, DA Thompson, MC Giordano, D Perla, J Rosenthal, TC TEMINEX HLTH CARE PLAN 900 GUARANTY BLDG BUFFALO NY 14202 USA

The objective of the study teas to identify factors that affected the implementation ion of an inpatient case measurement program In rural hospitals, The hospitals studied were from the Western New York Rural Health Care Cooperative. Five of the hospitals implemented the program in 1992. A qualitative evaluation was conducted by analyzing tape-recorded interviews with nurses and chief executive officers to identify obstacles to and facilitators of program implementation. Many obstacles to implementation could be traced to workload and time constraints, physician autonomy concern, and limited nursing staff and physician participation. Implementation was facilitated foremost by the effort and supportive attitudes of nursing leaders and hospital chief executive officers. This study concluded that it should be possible to successfully implement conceptually sound managed cave and case management programs in rural hospitals, but it will require a relatively long period of support, especially from hospital administration and nursing leaders.

关键词：病例管理/组织和管理临床路径卫生服务研究医院乡村/组织和管理住院病人医务人员医院纽约护理人员医院规划制订方案评价工作负荷量

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What is the difference between absence tracking and case management?

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AAOHN journal : official journal of the American Association of Occupational Health Nurses 2002年第7期50卷 299-300页

作者： Kalina, Christine M Haag, Annette B William Wrigley Company Chicago Illinois United States

At the request of our readers, we present this special feature on case management. This feature appears on an occasional basis in the Journal. Based on the suggestion of a reader, we are using a Panel approach to provide a forum for sharing ideas, viewpoints, and perspectives. We have put together a group of individuals with expertise from a variety of case management arenas who have agreed to share their opinions and perspectives in response to specific questions or scenarios. Opinions and perspectives are those of the panel members, and do not necessarily represent the views of the AAOHN, the Editor, or the Publisher. We encourage readers to submit their questions or scenarios for the Panel. This month's Panel members include Christine M. Kalina, Annette B. Haag, Robin Tourigian, and Mary Lou Wassel.

关键词：缺勤病例管理/组织和管理人类

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