摘要:

A new “episode of care” definition of emergency care was developed, consisting of the emergency department encounter and all subsequent, related care delivered within 48 hrs from the Initial contact. Data were analyzed by ICD-9-CM Major Diagnostic Category (MDC) and surgical Intervention using 1.6 million episodes generated by 809,145 separate patients from a national claims database. Secondary/adjunct services were a major component of episode charges. For several MDCs, hospitalization and/or surgical procedures were also major determinants of overall episodic charges. Results support the premise that economic analysis and reimbursement of emergency care benefits from the use of episodic data.

ISSN:0148-9917    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

Home health care programs have direct and indirect effects within a health care system. A complete cost-benefit evaluation would include all such effects. A study of New Brunswick's Extra-Mural Hospital (EMH) home health care program used population-based administrative data on physician services utilization to examine whether home care services act indirectly as substitutes for physician services. Evidence suggests that the introduction and expansion of New Brunswick's EMH home health care program had unanticipated substitution effects, which reduced health system costs by reducing the rate of growth of per-capita utilization of physician services.

ISSN:0148-9917    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

By relating health care resources and their use to health outcomes, through a coherent macro resource allocation framework, one can examine the health care system for allocative efficiencies. In this article, costs and outcomes are analyzed in such a framework, scenarios for optimizing the use of health care resources—while still maintaining existing health outcomes—are explored, and the implications for ambulatory care are discussed. The research clearly shows that much can be done to make health care systems more efficient without jeopardizing health outcomes.

ISSN:0148-9917    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

The community health center movement, begun in Saskatchewan, is central to successfully reforming the Canadian health care system. The arguments of 30 years ago are relevant today. Canadian Medicare is at the crossroads. The evidence shows that the provision of primary health care through community health centers is cost effective and that the quality of care is at least as high in these settings as in traditional fee-for-service settings. Each province must encourage the development of a network of community health centers capable of providing services to every resident who wishes to receive all of his or her primary care “under one roof.”

ISSN:0148-9917    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

This article examines the field of outcomes research from the perspective of a managed care organization, The Fallon Healthcare System, currently involved in many different types of studies. Outcome studies are characterized by the types of questions they examine. The cost and labor implications for each category are examined. Finally, a partnership among different participants in the outcome research field, including managed care organizations, academic institutions, and pharmaceutical companies, is proposed.

ISSN:0148-9917    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

This article presents our principles for developing performance measures to assess the quality of ambulatory care. The measures were developed as part of a project for developing and evaluating methods to promote ambulatory care quality (DEMPAQ). We describe our design for the performance measures, present examples of the DEMPAQ review criteria, and show the formats we used to feed back information to physicians. We conclude by presenting the results of our appralsal of the performance measures showing how evaluation can aid in the interpretation of measurement findings.

ISSN:0148-9917    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

This article investigates the relationship between three types of measures obtained from consumer surveys: satisfaction, health status, and report of systems performance. Analyses demonstrate that patient reports of the quality of processes of care or system performance (such as receiving results of tests or receiving conflicting information from staff members) are significantly related to satisfaction independently of perception of health status. Since dissatisfaction is known to be associated with disenrollment, patient reports of system performance are of great interest to health plans.

ISSN:0148-9917    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

The health care provider, whether an individual or an institution, needs to pay attention to appropriate mechanisms to ensure payment for services or repayment for benefits provided. While statutes provide some protection for large institutions, including health care providers, individual health care providers often are left to their own devices. The employment of a well drafted voluntary lien agreement can not only secure a right of recover against a patient, but where the patient pursues a personal injury claim through an attorney, can also give the health care provider recourse to patient's attorney. Knowing how to assert these liens, what funds are reachable by these lien, and what time factors must be adhered to in order to make the liens effective, are vital to a health care provider's financial well-being.

ISSN:0148-9917    

出版商:OVID    

年代:1995

数据来源: OVID

ISSN:0148-9917    

出版商:OVID    

年代:1995

数据来源: OVID