摘要:

Not only have the elderly benefited but the existing health care system has flourished with Medicare. In the years immediately following introduction of Medicare, evidence began to accumulate that more than an infusion of money was necessary to improve health care. The documentary history of Medicare reveals serious flaws in regard to cost and quality control. Reports of the Health Insurance Benefits Advisory Council, Congressional groups, the General Accounting Office, and other agencies pinpointed specific deficiencies and recommended changes. Response to these recommendations has been slow. Quality and cost control mechanisms of most current third-party payors and provider-groups have proved inadequate.Quality and cost control measures in Medicare are inextricably linked. While good modern health care is expensive, several irrationalities in the present health care system both add to the cost and detract from the quality of care provided in Medicare.Several action recommendations are offered.

ISSN:0025-7079    

出版商:OVID    

年代:1974

数据来源: OVID

摘要:

The study examines Medicaid utilization patterns, determining the extent to which Medicaid recipients in a Chicago community use hospitals in their own communities. Data from the February, 1970, Hospital Discharge Study shows that substantial numbers of Medicaid patients bypass nearby community hospitals and receive care instead in more distant teaching hospitals. In addition to possible harmful medical consequences, this pattern turns out to be much more expensive to the state's Medicaid program than care in closer community hospitals would be. Possible reasons for these patterns are suggested, implications for planning are discussed, and questions for further research are identified.

ISSN:0025-7079    

出版商:OVID    

年代:1974

数据来源: OVID

摘要:

Concern for reliable medical care data is frequently expressed at the federal level of government. Such data are, however, already widely collected at the local level of government This paper demonstrates how a Department of Pediatrics can build a local data system for the child population, using household interviews and supplementing these with data abstracted from the local Medicaid payment files. The latter approach is of special importance for the evaluation of health centers designed to serve specific poverty areas.Major changes in the child health care system occurred in 1969. A new health center became fully operative in one of the two local poverty areas. Medicaid eligibility criteria were changed, the welfare rolls increased, and private practitioners began to withdraw from the Medicaid program after a 20 per cent fee cut was enacted. The Medicaid payment files of 1968 and 1970 were therefore compared to study the effects of these changes. The health center provided 10,000 more services to children in the target area, which led to a decrease of 2,000 hospital clinic visits, 500 private doctor visits, and 300 private dentist visits. In contrast, the second poverty area had 2,000 more privnte doctor visits, 1,000 more private dentist visits, 400 more hospital clinic visits and 600 more other clinic visits.

ISSN:0025-7079    

出版商:OVID    

年代:1974

数据来源: OVID

摘要:

A sample of 5,271 legend drug prescriptions and over-the-counter pharmacy orders submitted to the New York City Medicaid Program was analyzed. The distribution of medications and supplies by therapeutic category is presented in detail, as a reference document for comparison with other pharmaceutical programs. To facilitate comparisons, the study utilized the clearly defined therapeutic categories of the Formulary of the American Society of Hospital Pharmacists. Although no other recent study of the total prescription pattern for a low-income population exists, the distribution observed basically parallels findings for general populations. Specific areas in which differences were noted relate to the structure of health care services for New York City's indigent population, and to desirable decreased prescribing of abusable items for which the New York City Medicaid Program requires prior authorization.The average cost per prescription or order ($3.79) was unexceptional, and the proportion of medications prescribed generically (13%) was equal to or larger than that found in other studies. However, the authors feel that administrative changes, combined with physician education, can greatly increase generic prescribing and thereby reduce costs significantly. A current plan to encourage generic dispensing is discussed.

ISSN:0025-7079    

出版商:OVID    

年代:1974

数据来源: OVID

摘要:

The utilization of emergency medical services has risen substantially in recent years, and the need for better organized systems of emergency transportation, communication, and treatment has become increasingly evident. This paper reviews the role of systems analysts techniques in the planning and evaluation of community emergency services. The actual application of an emergency system model is described as part of a comprehensive study of emergency care delivery in an urban area. Selected results illustrate the implications of proposed system configurations and the potential benefits of similar efforts in other communities.

ISSN:0025-7079    

出版商:OVID    

年代:1974

数据来源: OVID

摘要:

A ten-year study of a cohort of welfare cases in New York City investigated the impact of Medicaid on access to medical care and utilization patterns. Five waves of home interviews were conducted, three before and two after Medicaid. In the original 1,681 families, 346 respondents died by the last interview wave; but more than three-quarters of those living were interviewed after Medicaid. This paper reports on the 729 respondents interviewed in full on each wave. Use of services, health status, and attitudes to care were compared for a two-year period pre-Medicaid (within 1961-64) and a two-year period post-Medicaid (within 1968-71).The old and very sick (Old Age Assistance and Aid to Disabled welfare categories) actually received less care post-Medicaid, despite being seven years older. Under the previous welfare medical care system, whatever its imperfections of quality or acceptability, they apparently had ready access to a doctor and made many visits. Few untreated conditions could be found. Medicaid seems to have benefited most the younger and less sick members of this panel of low-income families. The proportion seeing a doctor rose post-Medicaid, and the average visits per patient increased.

ISSN:0025-7079    

出版商:OVID    

年代:1974

数据来源: OVID

摘要:

The expanded interest in ambulatory care evaluation and planning data has not included studies of the utilization of physical facilities by patients and professionals. The absence of such information has resulted in a delay of ambulatory facility planning and operation, as well as architectural programs that develop from inadequate and inappropriate sources. By examining the patterns of spatial utilization in an existing prepaid group practice serving an enrolled population, this article develops a methodology for studying existing facilities and programming future resource requirements.

ISSN:0025-7079    

出版商:OVID    

年代:1974

数据来源: OVID

ISSN:0025-7079    

出版商:OVID    

年代:1974

数据来源: OVID

ISSN:0025-7079    

出版商:OVID    

年代:1974

数据来源: OVID