ISSN:0025-7079    

出版商:OVID    

年代:1969

数据来源: OVID

摘要:

Public interest in moderating the continuing rise in health care expenditures has intensified, owing to the marked acceleration in both expenditures and prices in recent years. It is suggested here that proposals for achieving reduced expenditures or moderation in the rate of increase be appraised in terms of current knowledge. With three types of problem area taken as illustrations, different conclusions seem warranted. It is believed that the time has come to move to curtail the supply of hospital beds, in order to limit use. The current evidence on the effect of prepaid group practice is regarded as insufficiently sturdy to warrant an active policy of promotion. However, specific studies that promise early results are indicated. In the area of provider reimbursement, existing merchanisms are clearly deficient. A good deal of research is needed, as well as possibly experiments in diverse arrangements for payment.

ISSN:0025-7079    

出版商:OVID    

年代:1969

数据来源: OVID

摘要:

Post-payment is proposed as a supplement to current medical expense coverages. Under post-payment, a Blue Cross-Blue Shield Plan or insurance company would pay all of a policyholder's medical expenses, possibly excluding certain minor items. The individual would repay the insurer for the difference between total medical expenses and his prepayment benefits, such repayment being over several months or years if desired. The interest on “postpayment loans” would be lower than rates charged by commercial lending institutions. Bad-debt losses arising from post-payment could be offset by a low premium charge, discounting of bills, or through the interest charge. The post-payment recommendation presumes that purchasers of medical expense insurance will continue to be unwilling to pay the price for adequate prepayment coverage. Details concerning eligibility, benefits and premiums for postpayment are set forth. The implications of the new concept for insureds, insurers, hospitals, physicians and governmental programs are explored.

ISSN:0025-7079    

出版商:OVID    

年代:1969

数据来源: OVID

摘要:

The family doctor's medical care for emotional problems in a prepaid group practice plan during a period when mental health services were limited to psychiatric consultation is compared with the situation two years later when services included psychiatric treatment at no cost to the patient. During this time the annual rates for psychiatric consultation increased from 7 to 11 per 1000. There was a greater tendency during the later period to prescribe a wider range of drugs, and stronger drugs. Psychiatric referrals for patients with a wide range of emotional problems, including those whose emotional problems interfered with three or more life activities and those whose emotional problems caused no interference, increased. There was an increased tendency in the later period to refer patients whose self-reports described less serious or less acute problems.

ISSN:0025-7079    

出版商:OVID    

年代:1969

数据来源: OVID

摘要:

Utilization of medical care before and after implementation of an extended-benefit program by octogenarian retirees from the automobile industry is described. The initial impact of the new health benefits indicates that more people receive medical treatment; this finding holds for all types of care— hospital, nursing home, operations, and physician contacts. The findings also suggest the limited utility of social factors as predictors of differences in medical care utilizations, unlike the findings of studies of younger age groups.

ISSN:0025-7079    

出版商:OVID    

年代:1969

数据来源: OVID

摘要:

The authors point out that planning is a dynamic process in which real forces must be understood, and brought to a point of realization, before abstractly conceived plans can be made operative. This process is sometimes political, is in any case pragmatic. The ideal approach to planning, which merely balances need with resources, is likely to be rendered inoperative by opposing forces in life. The result has been slow progress for health planners, but progress may be accelerated by the pragmatic approach. Pragmatism, however, does not obviate the need for hard data. These are needed above all for evaluation.

ISSN:0025-7079    

出版商:OVID    

年代:1969

数据来源: OVID

ISSN:0025-7079    

出版商:OVID    

年代:1969

数据来源: OVID

摘要:

A Markovian planning model is presented. It takes into account the dynamics of the health services system and allows health planners flexibility in a continuously changing environment Analysis of the Markovian model leads to its three applications: 1) prediction, i.e., determining future requirements for manpower and resources for any population defined in terms of desired or specified demographic and/or eptdcmiologic characteristics; 2) simulation, i.e., analysis of changes in the health services system and/or in demographic and/or epidemiologic variables and the repercussions of these changes on present and future resources; 3) goal seeking, i.e, the design of several alternative strategies of reaching, in a given time period, specified utilization patterns or organizational arrangements, and the choice of the “best” alternative according to defined constraints such as “cost” or “minimum changes in current resources,” etc. The three applications of the model have been used in different situations. Empirical data from diverse sources has been used. Within the conceptual framework of the model the levels of care and the composition of population groups can be changed to meet desired criteria.

ISSN:0025-7079    

出版商:OVID    

年代:1969

数据来源: OVID

ISSN:0025-7079    

出版商:OVID    

年代:1969

数据来源: OVID

ISSN:0025-7079    

出版商:OVID    

年代:1969

数据来源: OVID