ISSN:1076-2752    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Employers are becoming increasingly concerned about rising pharmaceutical costs. Are improved health and cost outcomes achieved as a result of increasing pharmaceutical costs? One should approach this issue with a holistic view that considers the overall impact that disease conditions have on health and productivity. To illustrate, we first identified the “top ten” most expensive physical and mental health concerns facing American businesses, using data from over 60 firms from the 1996 MarketScan®Private Pay Fee-For-Service Research Database. For some of these top ten conditions, the literature already addresses the drug cost versus investment issue, with mixed results. For conditions in which uncertainty prevails and for other high-cost conditions, empirical analyses should address the drug cost versus investment issue to minimize the risk of a penny-wise and pound-foolish payment/coverage policy. A similar strategy should be applied to individual corporate diagnostic assessments.

ISSN:1076-2752    

出版商:OVID    

年代:2000

数据来源: OVID

ISSN:1076-2752    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

A steering committee and investigators from the American College of Occupational and Environmental Medicine (ACOEM) designed and carried out the ACOEM Practice Guidelines Dissemination Project to encourage adoption of theACOEM Occupational Medicine Practice Guidelines.The project also involved research on guideline acceptance as well as potential improvements and additions to the guidelines. To increase guideline adoption and use in improving the appropriateness and consistency of practice and case management, the design was based on existing research on guideline format, education, and adoption efforts. This article summarizes that information and the needs assessment done prior to case-based guidelines training. Other articles in this issue report on guideline adoption and use and the results of the market research on the ACOEM guidelines.

ISSN:1076-2752    

出版商:OVID    

年代:2000

数据来源: OVID

ISSN:1076-2752    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

The authors conducted a survey to ascertain post-training attitudes and self-reported use of the American College of Occupational and Environmental Medicine occupational medicine practice guidelines. Trainees were surveyed 3 to 4 months after completing a case-based practice ACOEM occupational practice guidelines seminar. Of 96 physician respondents, 95% reported that the guidelines improved their practice in some manner. Fifty-two percent of physicians thought that guideline use decreased medical costs. Seventy-one percent reported that their care complied with the guidelines in 70% or more of their cases; however, “actually considering the guidelines in particular cases” was reported by only 47%. Discussion of cases was frequent (92%) and involved physicians, patients, and other health care providers. We concluded that physicians’ attitudes toward the guidelines are positive and that reported compliance is high. Guidelines are discussed frequently.

ISSN:1076-2752    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Workers’ compensation case managers and adjusters have increased their use of practice guidelines recently, partly in response to state regulations. However, informally reported rates of use are not as high as desired for the best managed care practices and the greatest reductions in lost work time. Although there are several studies of physicians’ use of guidelines, there are few if any studies about case managers’ and adjusters’ beliefs about, and utilization of, either general medical or occupational medical practice guidelines. Information about attitudes, beliefs about practice guidelines, and actual use should help developers make the guidelines more usable and bring about more effective interaction among case managers, adjusters, treating physicians, and other health professionals. This article reports on pre- and post-training surveys of a cohort of case managers and adjusters who participated in a case-based guideline training course. It then compares their responses to those of the physicians whose cases they might manage.

ISSN:1076-2752    

出版商:OVID    

年代:2000

数据来源: OVID

ISSN:1076-2752    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

The American College of Occupational and Environmental Medicine’s Practice Guideline Dissemination Project included market research to better understand the wants and needs of physicians, case managers, and insurance adjusters who used the guidelines. We used structured and open-ended survey questions and focus groups administered to a cohort of physicians, adjusters, and case managers trained as part of the project. Respondents were generally satisfied with the format and contents of the guidelines. They requested additional material on case management and facilitation of effective treatment and return to work by other health professionals. They also suggested a variety of formats to improve the accessibility of the guidelines. The suggestions may be used in new product development or for guideline revisions.

ISSN:1076-2752    

出版商:OVID    

年代:2000

数据来源: OVID

ISSN:1076-2752    

出版商:OVID    

年代:2000

数据来源: OVID