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Developments in health care risk management.

Journal of healthcare risk management : the journal of the American Society for Healthcare Risk Management 1996年第3期16卷 3-6页

作者： Harri, S. Aon New York City Alliance United States

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Physician views on practicing professionalism in the corporate age

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QUALITATIVE HEALTH RESEARCH 2000年第4期10卷 490-506页

作者： Castellani, B Wear, D Northeastern Ohio Univ Coll Med Dept Behav Sci Rootstown OH 44272 USA

Arnold Relman argues that medical education does not prepare students and residents to practice their profession in today's corporate health care system. Corporate health care administrators agree: Physicians enter the workforce unskilled in contract negotiation, evidence-based medicine, navigating bureaucratic systems, and so forth. What about practicing physicians? Do they agree as well? According to this study, they do. Feeling like decentered double agents and unprepared, physicians find themselves professionally lost, struggling to balance issues of cost and care and expressing lots of negativity toward the cultures of medicine and managed care. However, physicians are resilient. A group of physicians, who may be called proactive, are meeting the professional demands of corporate health care by becoming sophisticated about its bureaucratic organization and the ways in which their professional and personal commitments fit within the system. Following the lead of proactive physicians, the auf hors support Relman's thesis that education for both students and physicians requires a major overhaul.

关键词：医务工作者的态度教育医学管理医疗规划/组织和管理谈判组织文化医师/心理学政治权力(心理学) 诊疗工作管理医学/组织和管理诊疗工作管理医学/发展趋势专业能力美国人类

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Managed mental health care: A home grown product

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ADMINISTRATION AND POLICY IN MENTAL HEALTH 2001年第3期28卷 229-234页

作者： Smitson, WS Cent Clin Cincinnati OH 45229 USA Univ Cincinnati Coll Med Dept Psychiat Cincinnati OH 45221 USA

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Risk adjusting capitation: Applications in employed and disabled populations

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Health Care Management Science 2000年第2期3.0卷 101-109页

作者： Madden, Carolyn W. Mackay, Bret P. Skillman, Susan M. Ciol, Marcia Diehr, Paula K. Department of Health Services University of Washington Seattle WA 98195 United States Department of Economics University of Washington Seattle WA 98195 United States Department of Biostatistics University of Washington Seattle WA 98195 United States

Risk adjustment may be a sensible strategy to reduce selection bias because it links managed care payment directly to the costs of providing services. In this paper we compare risk adjustment models in two populations (public employees and their dependents, and publicly-insured low income individuals with disabilities) in Washington State using two statistical approaches and three health status measures. We conclude that a two-part logistic/GLM statistical model performs better in populations with large numbers of individuals who do not use health services. This model was successfully implemented in the employed population, but the managed care program for the publicly insured population was terminated before risk adjustment could be applied. The choice of the most appropriate health status measure depends on purchasers' principles and desired outcomes. © Baltzer Science Publishers BV.

关键词：按人收费/组织和管理残疾人筹资政府保健福利计划雇员/组织和管理健康状况保险选择偏倚 Logistic模型管理医疗规划/组织和管理 Medicaid/组织和管理贫困风险调节/组织和管理州卫生计划/组织和管理美国华盛顿青少年成年人老年人女(雌)性人类男(雄)性中年人

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Case management: Opportunities for service providers

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Home Health Care Services Quarterly 1993年第1期14卷 5-40页

作者： Williams, Judith K. Planning at the Miami Jewish Home and Hospital for the Aged United States

The notion of using case managers to coordinate care and services to the elderly has become increasingly popular. Case management appears to be seen by some as the route to reform and rationalization of the financing and provision of services. Little systematic research can be cited in making claims for its organization, efficacy or efficiency, yet opinions in this regard abound. Research and demonstration projects provide some insights but few conclusions to support the rhetoric of case management. Case management principles are enunciated and program options flow from them. A case is made for flexibility of organization and sensibility of provision. © 1993 Taylor & Francis Group, LLC.

关键词：利害冲突卫生政策/立法和法学卫生服务研究家庭医疗保健服务/组织和管理长期医疗/组织和管理管理医疗规划/组织和管理纽约病人医疗护理计划/组织和管理病人医疗护理计划/标准规划制订/方法规划制订/标准偿还途径/组织和管理州卫生计划/立法和法学美国老年人人类

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A provider assessment of the Massachusetts Medicaid Managed Behavioral Health Program: Year four

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ADMINISTRATION AND POLICY IN MENTAL HEALTH 1998年第4期25卷 411-426页

作者： Beinecke, RH Lockhart, A Suffolk Univ Dept Publ Management Boston MA 02108 USA

A stratified, random sample of 80 providers in the Massachusetts Medicaid Managed Mental Health/Substance Abuse Program were interviewed by phone to assess their views of the program in year four. Providers continued to believe that access and quality were the same or better than a year earlier, that client severity continued to increase while length of stay decreased, that readmissions and emergency room admissions were the same as a year earlier, and that aftercare was the same or better than a year earlier. Substantial problems were reported in the integration of services, in linkages with support services, and with administration of the program.

关键词：医务工作者的态度卫生保健提供联合/组织和管理卫生服务易得程度/标准住院时间/统计学和数值数据住院时间/发展趋势管理医疗规划/组织和管理马萨诸塞 Medicaid/组织和管理精神卫生服务/组织和管理方案评价卫生保健质量问卷调查州卫生计划/组织和管理物质滥用治疗中心/组织和管理美国成年人儿童人类

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Importing employer-based managed care initiatives to rural areas: The experience of the South Dakota state employees group

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JOURNAL OF RURAL HEALTH 1997年第2期13卷 145-151页

作者： Christianson, JB Hart, JP UNIV MINNESOTA SCH PUBL HLTHRURAL HLTH RES CTRINST HLTH SERV RESBOX 729MINNEAPOLISMN 55455 USA

In urban areas, employers are frequently in the forefront of efforts to implement managed care initiatives at the community level, either individually or through coalitions. While employer-driven managed care initiatives also exist in rural areas, they are less common and much less is known about them. This article describes and analyzes the early experience of a large rural employer-the state of South Dakota-in its attempt to develop and implement a managed care initiative. Several aspects of that experience suggest that employer-driven managed care models in urban sites may require reexamination and redefinition for implementation in rural areas.

关键词：社区网络/组织和管理合同业务保健福利计划雇员/组织和管理管理医疗规划/组织和管理卫生服务使用研究试点项目乡村卫生服务/组织和管理乡村卫生服务/发展趋势南达科他专业医学州政府人类

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Risk adjustment and the fear of markets: The case of Belgium

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Health Care Management Science 2000年第2期3卷 121-130页

作者： Schokkaert, Erik Van De Voorde, Carine Center for Economic Studies KU Leuven Leuven Belgium

In Belgium the management and administration of the compulsory and universal health insurance is left to a limited number of non-governmental non-profit sickness funds. Since 1995 these sickness funds are partially financed in a prospective way. The risk adjustment scheme is based on a regression model to explain medical expenditures for different social groups. Medical supply is taken out of the formula to construct risk-adjusted capitation payments. The risk-adjustment formula still leaves scope for risk selection. At the same time, the sickness funds were not given the instruments to exert a real influence on expenditures and the health insurance market has not been opened for new entrants. As a consequence, Belgium runs the danger of ending up in a situation with little incentives for efficiency and considerable profits from cream skimming. © Baltzer Science Publishers BV.

关键词：比利时按人收费/组织和管理效率组织筹资政府/组织和管理预测卫生经费支出/统计学和数值数据保险选择偏倚管理医疗规划/组织和管理卫生服务使用研究/组织和管理国家卫生规划/组织和管理回归分析风险调节/组织和管理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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Managing risks in managed care environment.

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Journal of healthcare risk management : the journal of the American Society for Healthcare Risk Management 1998年第3期18卷 6-14页

作者： Saxton, J.W. Stevens &amp Lancaster PA United States

The healthcare environment is rapidly changing as managed care penetrates your community. Risk management in the office setting is becoming more critical as the strategies for preventing claims in the first place become more important. It is time to reexamine the environment that is being created, increase the involvement of patients in their own care, create documentation systems and recognize when you are at risk.

关键词：文献工作表格和记录管理知情同意管理医疗规划/组织和管理办公室管理工作/标准诊室就医病人满意度诊疗工作管理医学/组织和管理职业病人关系卫生保健质量危险处理/方法美国人类

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The marketing function in managed care systems

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Health Marketing Quarterly 1999年第2期17卷 43-54页

作者： Fleming, Kae Short, Mike Warren, William E. Columbia State Community College Columbia TN 38402-1315 Box 1315 United States Maury Regional Hospital Columbia TN 38401 1224 Trotwood Avenue United States Middle Tennessee State University Murfreesboro TN 37132 MTSU Box X030 United States

As managed care spreads through the health care service industry, marketing professionals are faced with the challenge of marketing highly integrated systems. This paper explores three questions related to this development: (1) what is unique about managed care marketing, (2) how has managed care impacted health care marketing, and (3) what new strategies and trends will shape these developing markets? © 1999 by The Haworth Press, Inc. All rights reserved.

关键词：卫生保健提供联合/组织和管理卫生保健部门管理医疗规划/组织和管理卫生服务使用研究/方法卫生服务使用研究/组织和管理生产线管理美国

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