Prevention in managed care: obstacles and opportunities.

J E Bailey, R J Womeodu
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Abstract

Managed care will present many new challenges to health care providers in their efforts to improve the quality of the preventive care their patients receive. Managed care will present both formidable obstacles to prevention and previously unknown opportunities to enhance population-based preventive services. Whether these opportunities are realized depends on the degree and quality of the involvement of health care providers in managed care institutions. Provider and public health input is particularly needed to promote the development of uniform preventive care standards, the development of information systems for continuous monitoring of preventive service delivery, and to enhance clinic-based preventive efforts, and the development of reimbursement mechanisms that provide incentives for prevention. Independent research and oversight is needed to show the impact of various types of managed care on preventive service delivery and quality of care. The effects of managed care on the preventive care that patients receive will ultimately be determined by the quality, priorities, and determination of the management.

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管理式医疗中的预防:障碍与机遇。
管理护理将提出许多新的挑战,卫生保健提供者在他们的努力,以提高他们的病人接受预防性护理的质量。管理式医疗既会给预防带来巨大障碍,也会给加强以人口为基础的预防服务带来以前未知的机会。这些机会能否实现,取决于卫生保健提供者参与管理医疗机构的程度和质量。特别需要提供人员和公共卫生方面的投入,以促进制定统一的预防保健标准,开发信息系统,以便持续监测提供的预防服务,加强以诊所为基础的预防工作,以及制定奖励预防的补偿机制。需要进行独立的研究和监督,以显示各种类型的管理保健对提供预防服务和保健质量的影响。管理式护理对患者接受的预防性护理的影响最终将由管理的质量、优先级和决心决定。
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