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.
{"title":"Prevention in managed care: obstacles and opportunities.","authors":"J E Bailey, R J Womeodu","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>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.</p>","PeriodicalId":73992,"journal":{"name":"Journal of the Tennessee Medical Association","volume":"89 4","pages":"122-5"},"PeriodicalIF":0.0,"publicationDate":"1996-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19832038","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Breastfeeding promotion--a community consortium approach.","authors":"J Fleming, D J Turner","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":73992,"journal":{"name":"Journal of the Tennessee Medical Association","volume":"89 4","pages":"126, 128"},"PeriodicalIF":0.0,"publicationDate":"1996-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19832039","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Bilateral adrenal hemorrhage and acute addisonian crisis--a complication of antiphospholipid syndrome.","authors":"G W Garris, B D Smith","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":73992,"journal":{"name":"Journal of the Tennessee Medical Association","volume":"89 4","pages":"120"},"PeriodicalIF":0.0,"publicationDate":"1996-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19832036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Flotsam and Jetsam.","authors":"J B Thomison","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":73992,"journal":{"name":"Journal of the Tennessee Medical Association","volume":"89 4","pages":"132-3"},"PeriodicalIF":0.0,"publicationDate":"1996-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19833713","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A case of penicillin-resistant pneumococcal meningitis.","authors":"R Earnest","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":73992,"journal":{"name":"Journal of the Tennessee Medical Association","volume":"89 4","pages":"121"},"PeriodicalIF":0.0,"publicationDate":"1996-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19832037","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Outcomes can be very unexpected.","authors":"J K Avery","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":73992,"journal":{"name":"Journal of the Tennessee Medical Association","volume":"89 4","pages":"127-8"},"PeriodicalIF":0.0,"publicationDate":"1996-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19833712","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Thyroglossal duct cyst mass with Hashimoto's disease and non-Hodgkin's lymphoma.","authors":"W C Udoji","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":73992,"journal":{"name":"Journal of the Tennessee Medical Association","volume":"89 4","pages":"113-4"},"PeriodicalIF":0.0,"publicationDate":"1996-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19832033","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Diaphragmatic rupture.","authors":"J A Mathews, L B Somberg, D E Barker","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":73992,"journal":{"name":"Journal of the Tennessee Medical Association","volume":"89 4","pages":"117-9"},"PeriodicalIF":0.0,"publicationDate":"1996-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19832035","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Epigastric pain unrelieved by omeprazole.","authors":"L Weber","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":73992,"journal":{"name":"Journal of the Tennessee Medical Association","volume":"89 3","pages":"84-5"},"PeriodicalIF":0.0,"publicationDate":"1996-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19805722","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Since the isolation of human immunodeficiency virus (HIV), numerous laboratory tests have been developed to confirm the immunologic response to the virus. In 1991, the state of Tennessee mandated that clinical laboratories performing Western blot analyses for HIV report all new cases of confirmed HIV infection. This report is a summary of HIV confirmed cases evaluated by this facility from 1985 until July 1, 1995. During each year, the laboratory screens approximately 20,000 persons for HIV and all positive screens are confirmed by an FDA-approved Western blot. During the period described, the laboratory has confirmed HIV serologic positivity in 4,096 individuals, principally from Shelby County and surrounding Tennessee counties. Although these data are not complete, they clearly indicate that we have a continuing problem with this infectious disease. Based on the current rate of positive cases seen thus far in 1995, this facility may confirm nearly 900 new cases of HIV infection in this year alone.
{"title":"Ten-year summary of human immunodeficiency virus serology in west Tennessee.","authors":"M F Hall, D L Smalley, M V Stevens","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Since the isolation of human immunodeficiency virus (HIV), numerous laboratory tests have been developed to confirm the immunologic response to the virus. In 1991, the state of Tennessee mandated that clinical laboratories performing Western blot analyses for HIV report all new cases of confirmed HIV infection. This report is a summary of HIV confirmed cases evaluated by this facility from 1985 until July 1, 1995. During each year, the laboratory screens approximately 20,000 persons for HIV and all positive screens are confirmed by an FDA-approved Western blot. During the period described, the laboratory has confirmed HIV serologic positivity in 4,096 individuals, principally from Shelby County and surrounding Tennessee counties. Although these data are not complete, they clearly indicate that we have a continuing problem with this infectious disease. Based on the current rate of positive cases seen thus far in 1995, this facility may confirm nearly 900 new cases of HIV infection in this year alone.</p>","PeriodicalId":73992,"journal":{"name":"Journal of the Tennessee Medical Association","volume":"89 3","pages":"79-80"},"PeriodicalIF":0.0,"publicationDate":"1996-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19805719","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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