Pub Date : 1994-01-01DOI: 10.1177/107755879405100203
A Crichton
{"title":"Health insurance and medical practice organization in Canada: findings from a literature review.","authors":"A Crichton","doi":"10.1177/107755879405100203","DOIUrl":"https://doi.org/10.1177/107755879405100203","url":null,"abstract":"","PeriodicalId":79684,"journal":{"name":"Medical care review","volume":"51 2","pages":"149-77"},"PeriodicalIF":0.0,"publicationDate":"1994-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/107755879405100203","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21005783","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}
Pub Date : 1994-01-01DOI: 10.1177/107755879405100205
B Bigelow, M Arndt
able body of literature has emerged that urges the transfer of practices common in private industry into the hospital industry. Hospitals are encouraged, for example, to diversify or to develop more sophisticated management systems if they wish to strengthen their competitive position and improve their financial performance. What evidence exists suggests that hospitals have taken these encouragements to heart, presumably to survive and thrive in the changed environment. In this article, the literature describing four such strategies is presented : diversification into long-term care and into ambulatory care centers, and adoption of product line management and cost accounting systems. A close examination of this literature is disquieting. Each strategy has a number of benefits attributed to it. Among others, diversification into long-term care will improve a hospital’s public image (Giardina
{"title":"Great expectations: an analysis of four strategies.","authors":"B Bigelow, M Arndt","doi":"10.1177/107755879405100205","DOIUrl":"https://doi.org/10.1177/107755879405100205","url":null,"abstract":"able body of literature has emerged that urges the transfer of practices common in private industry into the hospital industry. Hospitals are encouraged, for example, to diversify or to develop more sophisticated management systems if they wish to strengthen their competitive position and improve their financial performance. What evidence exists suggests that hospitals have taken these encouragements to heart, presumably to survive and thrive in the changed environment. In this article, the literature describing four such strategies is presented : diversification into long-term care and into ambulatory care centers, and adoption of product line management and cost accounting systems. A close examination of this literature is disquieting. Each strategy has a number of benefits attributed to it. Among others, diversification into long-term care will improve a hospital’s public image (Giardina","PeriodicalId":79684,"journal":{"name":"Medical care review","volume":"51 2","pages":"205-32"},"PeriodicalIF":0.0,"publicationDate":"1994-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/107755879405100205","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21005785","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}
Pub Date : 1994-01-01DOI: 10.1177/107755879405100403
P V Rosenau
The medications that are being made available upon demand are not just those that &dquo;relieve symptoms of minor, self-limiting conditions.&dquo; They include medications of substantial importance that &dquo;prevent diseases&dquo; and &dquo;manage chronic conditions&dquo; (Young 1988, 6).5 Future switches are likely to continue in this direction. For example, Shering Plough Health Care will apply to the Food and Drug Administration (FDA) to sell oral contraceptives over the counter (Angier 1993). Neither are the financial dimensions of the Rx-to-OTC switch trivial. Switched
{"title":"Rx-to-OTC switch movement.","authors":"P V Rosenau","doi":"10.1177/107755879405100403","DOIUrl":"https://doi.org/10.1177/107755879405100403","url":null,"abstract":"The medications that are being made available upon demand are not just those that &dquo;relieve symptoms of minor, self-limiting conditions.&dquo; They include medications of substantial importance that &dquo;prevent diseases&dquo; and &dquo;manage chronic conditions&dquo; (Young 1988, 6).5 Future switches are likely to continue in this direction. For example, Shering Plough Health Care will apply to the Food and Drug Administration (FDA) to sell oral contraceptives over the counter (Angier 1993). Neither are the financial dimensions of the Rx-to-OTC switch trivial. Switched","PeriodicalId":79684,"journal":{"name":"Medical care review","volume":"51 4","pages":"429-66"},"PeriodicalIF":0.0,"publicationDate":"1994-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/107755879405100403","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21011259","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}
Pub Date : 1994-01-01DOI: 10.1177/107755879405100102
W J Moore
During the 1980s, prescription drug costs increased faster than other components of the Medicaid budget. In 1980, total vendor payments for prescription drugs were $1.3 billion, or 5.7 percent of all Medicaid expenditures. By 1990, prescription drug expenditures had risen to $4.4 billion, or 6.3 percent of the Medicaid budget (National Pharmaceutical Council 1991). Faced with this expenditure pattern and increasing federal deficits, Congress included a provision in the Omni-
{"title":"Medicaid drug utilization review: a critical appraisal.","authors":"W J Moore","doi":"10.1177/107755879405100102","DOIUrl":"https://doi.org/10.1177/107755879405100102","url":null,"abstract":"During the 1980s, prescription drug costs increased faster than other components of the Medicaid budget. In 1980, total vendor payments for prescription drugs were $1.3 billion, or 5.7 percent of all Medicaid expenditures. By 1990, prescription drug expenditures had risen to $4.4 billion, or 6.3 percent of the Medicaid budget (National Pharmaceutical Council 1991). Faced with this expenditure pattern and increasing federal deficits, Congress included a provision in the Omni-","PeriodicalId":79684,"journal":{"name":"Medical care review","volume":"51 1","pages":"3-37"},"PeriodicalIF":0.0,"publicationDate":"1994-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/107755879405100102","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21005106","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}
Pub Date : 1994-01-01DOI: 10.1177/107755879405100204
N L McKay
common sight in the health press. The president of the American Hospital Association, for instance, urged hospitals to move into a &dquo;new era of cooperation&dquo; in order to meet community health needs.1 Unfortunately, cooperative efforts among hospitals may often fail, in spite of the potential gains from cooperation. The explanation for this conundrum lies in a model called the prisoner’s dilemma. The prisoner’s dilemma, which describes a situation in which deci-
{"title":"The prisoner's dilemma: an obstacle to cooperation in health care markets.","authors":"N L McKay","doi":"10.1177/107755879405100204","DOIUrl":"https://doi.org/10.1177/107755879405100204","url":null,"abstract":"common sight in the health press. The president of the American Hospital Association, for instance, urged hospitals to move into a &dquo;new era of cooperation&dquo; in order to meet community health needs.1 Unfortunately, cooperative efforts among hospitals may often fail, in spite of the potential gains from cooperation. The explanation for this conundrum lies in a model called the prisoner’s dilemma. The prisoner’s dilemma, which describes a situation in which deci-","PeriodicalId":79684,"journal":{"name":"Medical care review","volume":"51 2","pages":"179-204"},"PeriodicalIF":0.0,"publicationDate":"1994-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/107755879405100204","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21005784","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}
Pub Date : 1994-01-01DOI: 10.1177/107755879405100302
T Rice, K R Morrison
{"title":"Patient cost sharing for medical services: a review of the literature and implications for health care reform.","authors":"T Rice, K R Morrison","doi":"10.1177/107755879405100302","DOIUrl":"https://doi.org/10.1177/107755879405100302","url":null,"abstract":"","PeriodicalId":79684,"journal":{"name":"Medical care review","volume":"51 3","pages":"235-87"},"PeriodicalIF":0.0,"publicationDate":"1994-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/107755879405100302","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21009236","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}
Pub Date : 1994-01-01DOI: 10.1177/107755879405100402
A B Flood
{"title":"The impact of organizational and managerial factors on the quality of care in health care organizations.","authors":"A B Flood","doi":"10.1177/107755879405100402","DOIUrl":"https://doi.org/10.1177/107755879405100402","url":null,"abstract":"","PeriodicalId":79684,"journal":{"name":"Medical care review","volume":"51 4","pages":"381-428"},"PeriodicalIF":0.0,"publicationDate":"1994-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/107755879405100402","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21011258","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}
Pub Date : 1994-01-01DOI: 10.1177/107755879405100103
R P Hayes, M T Lundberg, D J Ballard
{"title":"Peer review organizations: scientific challenges in HCFA's health care quality improvement initiative.","authors":"R P Hayes, M T Lundberg, D J Ballard","doi":"10.1177/107755879405100103","DOIUrl":"https://doi.org/10.1177/107755879405100103","url":null,"abstract":"","PeriodicalId":79684,"journal":{"name":"Medical care review","volume":"51 1","pages":"39-60"},"PeriodicalIF":0.0,"publicationDate":"1994-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/107755879405100103","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21005107","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}
Pub Date : 1994-01-01DOI: 10.1177/107755879405100202
D Ermann, J Richmond
Between 1980 and 1991, national health spending increased from $250 billion to $752 billion a year (1993 Data Compendium 1993). This figure is projected to increase to $1.1 trillion by 1995, and $1.7 trillion by 2000 (Burner, Waldo, and McKusick 1992). As both public and private payers of health care continue to be stymied by the uncontrollable inflationary spiral, pressure on the federal government to reform
{"title":"Managed care arrangements: barriers to cost savings potential.","authors":"D Ermann, J Richmond","doi":"10.1177/107755879405100202","DOIUrl":"https://doi.org/10.1177/107755879405100202","url":null,"abstract":"Between 1980 and 1991, national health spending increased from $250 billion to $752 billion a year (1993 Data Compendium 1993). This figure is projected to increase to $1.1 trillion by 1995, and $1.7 trillion by 2000 (Burner, Waldo, and McKusick 1992). As both public and private payers of health care continue to be stymied by the uncontrollable inflationary spiral, pressure on the federal government to reform","PeriodicalId":79684,"journal":{"name":"Medical care review","volume":"51 2","pages":"125-48"},"PeriodicalIF":0.0,"publicationDate":"1994-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/107755879405100202","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21005780","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}
Pub Date : 1994-01-01DOI: 10.1177/107755879405100303
J A Chilingerian, M P Glavin
implementation of Medicare’s prospective payment system (Rice 1992). Managed care organizations are also pressuring physicians to discharge sooner and find the &dquo;quick route to health&dquo; for their patients (Chilingerian 1992). In 1992, Medicare instituted the resource-based relative value system (RBRVS), which put direct financial pressure on physicians to avoid using expensive hospital care and procedures, and also to penalize physicians as a group for exceeding service-volume and intensity standards (Fahey 1992). For the first time, the attending physician is being asked to manage hospital resources rather than merely to use them.
{"title":"Temporary firms in community hospitals: elements of a managerial theory of clinical efficiency.","authors":"J A Chilingerian, M P Glavin","doi":"10.1177/107755879405100303","DOIUrl":"https://doi.org/10.1177/107755879405100303","url":null,"abstract":"implementation of Medicare’s prospective payment system (Rice 1992). Managed care organizations are also pressuring physicians to discharge sooner and find the &dquo;quick route to health&dquo; for their patients (Chilingerian 1992). In 1992, Medicare instituted the resource-based relative value system (RBRVS), which put direct financial pressure on physicians to avoid using expensive hospital care and procedures, and also to penalize physicians as a group for exceeding service-volume and intensity standards (Fahey 1992). For the first time, the attending physician is being asked to manage hospital resources rather than merely to use them.","PeriodicalId":79684,"journal":{"name":"Medical care review","volume":"51 3","pages":"289-335"},"PeriodicalIF":0.0,"publicationDate":"1994-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/107755879405100303","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21009237","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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