Pub Date : 1993-01-01DOI: 10.1177/107755879305000205
S Strasser, L Aharony, D Greenberger
For a number of reasons, the topic of patient satisfaction has recently gained much attention by academicians and practitioners alike. First, there has been a proliferation of total quality management (TQM) programs in which patients are targeted as a critical consumer group (Berwick 1989). Second is the Joint Commission on Accreditation of Healthcare Organizations’ (JCAHO’s) requirement that all hospitals have a formal complaint management system (Section MA.1.4.11). A third reason is management’s recognition that satisfied patients are more likely to continue using medical care services (Ware et al. 1975; Thomas and
{"title":"The patient satisfaction process: moving toward a comprehensive model.","authors":"S Strasser, L Aharony, D Greenberger","doi":"10.1177/107755879305000205","DOIUrl":"https://doi.org/10.1177/107755879305000205","url":null,"abstract":"For a number of reasons, the topic of patient satisfaction has recently gained much attention by academicians and practitioners alike. First, there has been a proliferation of total quality management (TQM) programs in which patients are targeted as a critical consumer group (Berwick 1989). Second is the Joint Commission on Accreditation of Healthcare Organizations’ (JCAHO’s) requirement that all hospitals have a formal complaint management system (Section MA.1.4.11). A third reason is management’s recognition that satisfied patients are more likely to continue using medical care services (Ware et al. 1975; Thomas and","PeriodicalId":79684,"journal":{"name":"Medical care review","volume":"50 2","pages":"219-48"},"PeriodicalIF":0.0,"publicationDate":"1993-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/107755879305000205","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21000249","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 : 1993-01-01DOI: 10.1177/002570879305000403
J P Weiner
{"title":"The demand for physician services in a changing health care system: a synthesis.","authors":"J P Weiner","doi":"10.1177/002570879305000403","DOIUrl":"https://doi.org/10.1177/002570879305000403","url":null,"abstract":"","PeriodicalId":79684,"journal":{"name":"Medical care review","volume":"50 4","pages":"411-49"},"PeriodicalIF":0.0,"publicationDate":"1993-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/002570879305000403","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21003666","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 : 1993-01-01DOI: 10.1177/002570879305000402
B J Weiner, J A Alexander
{"title":"Hospital governance and quality of care: a critical review of transitional roles.","authors":"B J Weiner, J A Alexander","doi":"10.1177/002570879305000402","DOIUrl":"https://doi.org/10.1177/002570879305000402","url":null,"abstract":"","PeriodicalId":79684,"journal":{"name":"Medical care review","volume":"50 4","pages":"375-410"},"PeriodicalIF":0.0,"publicationDate":"1993-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/002570879305000402","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21003665","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 : 1993-01-01DOI: 10.1177/107755879305000203
H H Schauffler, T Rodriguez
In summary, the managed care system we propose for preventive services is designed to limit the potential for overcare under FFS payment and for undercare under capitation and comprehensive fixed fees. It bases payment on the provision of a complete set of preventive services, thus limiting the tendency of physicians to provide only the relatively high-profit services, such as screening tests, while neglecting the lower-profit services, such as counseling. It also allows primary care providers to outsource selected services to lower-cost providers, such as laboratories, health educators, and counselors, and community-based health promotion programs, thus encouraging greater efficiency. In addition, the proposed system funds both primary and high-risk preventive case management to ensure that individuals receive preventive services appropriate to their age, sex, and risk factors. Finally, the proposed system monitors the use of preventive services, relying on physician reminders to stimulate the appropriate provision of preventive care and denying payment for unauthorized care. Existing research suggests that none of the individual strategies for managed care can be expected to achieve all of the goals of managing and promoting the appropriate use of preventive services as defined by the U.S. Preventive Services Task Force (1989). To be most effective, we conclude that the strategies need to be coordinated and integrated into the current health care delivery practices of HMOs, PPOs, and point-of-service plans. In addition, the strategies require additional provider training in preventive care. With this support, the proposed model has the potential to improve quality, control costs, and increase the appropriate use of preventive care. While many of the individual components of the proposed managed care model have been evaluated for preventive services, a great deal more research is needed to evaluate the effect of combining these elements into a coordinated and comprehensive approach to managing preventive care. Research is also needed on workable ways to invite people not currently receiving medical care into the health care system to receive preventive care. To inform policy development, the impact of the proposed managed care model--both on preventive services utilization for specific screening, immunization, and counseling services, and on total health care costs and patient health status outcomes--needs to be evaluated.
{"title":"Managed care for preventive services: a review of policy options.","authors":"H H Schauffler, T Rodriguez","doi":"10.1177/107755879305000203","DOIUrl":"https://doi.org/10.1177/107755879305000203","url":null,"abstract":"<p><p>In summary, the managed care system we propose for preventive services is designed to limit the potential for overcare under FFS payment and for undercare under capitation and comprehensive fixed fees. It bases payment on the provision of a complete set of preventive services, thus limiting the tendency of physicians to provide only the relatively high-profit services, such as screening tests, while neglecting the lower-profit services, such as counseling. It also allows primary care providers to outsource selected services to lower-cost providers, such as laboratories, health educators, and counselors, and community-based health promotion programs, thus encouraging greater efficiency. In addition, the proposed system funds both primary and high-risk preventive case management to ensure that individuals receive preventive services appropriate to their age, sex, and risk factors. Finally, the proposed system monitors the use of preventive services, relying on physician reminders to stimulate the appropriate provision of preventive care and denying payment for unauthorized care. Existing research suggests that none of the individual strategies for managed care can be expected to achieve all of the goals of managing and promoting the appropriate use of preventive services as defined by the U.S. Preventive Services Task Force (1989). To be most effective, we conclude that the strategies need to be coordinated and integrated into the current health care delivery practices of HMOs, PPOs, and point-of-service plans. In addition, the strategies require additional provider training in preventive care. With this support, the proposed model has the potential to improve quality, control costs, and increase the appropriate use of preventive care. While many of the individual components of the proposed managed care model have been evaluated for preventive services, a great deal more research is needed to evaluate the effect of combining these elements into a coordinated and comprehensive approach to managing preventive care. Research is also needed on workable ways to invite people not currently receiving medical care into the health care system to receive preventive care. To inform policy development, the impact of the proposed managed care model--both on preventive services utilization for specific screening, immunization, and counseling services, and on total health care costs and patient health status outcomes--needs to be evaluated.</p>","PeriodicalId":79684,"journal":{"name":"Medical care review","volume":"50 2","pages":"153-98"},"PeriodicalIF":0.0,"publicationDate":"1993-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/107755879305000203","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21000247","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 : 1993-01-01DOI: 10.1177/002570879305000404
P S Romano
{"title":"Can administrative data be used to compare the quality of health care?","authors":"P S Romano","doi":"10.1177/002570879305000404","DOIUrl":"https://doi.org/10.1177/002570879305000404","url":null,"abstract":"","PeriodicalId":79684,"journal":{"name":"Medical care review","volume":"50 4","pages":"451-77"},"PeriodicalIF":0.0,"publicationDate":"1993-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/002570879305000404","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21003667","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 : 1993-01-01DOI: 10.1177/002570879305000304
R Catalano
{"title":"Managing the local economy: implications for medical care.","authors":"R Catalano","doi":"10.1177/002570879305000304","DOIUrl":"https://doi.org/10.1177/002570879305000304","url":null,"abstract":"","PeriodicalId":79684,"journal":{"name":"Medical care review","volume":"50 3","pages":"305-25"},"PeriodicalIF":0.0,"publicationDate":"1993-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/002570879305000304","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21001774","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 : 1993-01-01DOI: 10.1177/107755879305000204
R Bashshur, D G Smith, R A Stiles
Much research and policy attention in recent years has been drawn to the plight of the uninsured in the United States-the numbers of people with no health care coverage from any source, their demographics (as well as other characteristics and factors leading to access barriers), and their health status-all under circumstances of escalating costs and seemingly inevitable uncompensated care (Brown 1989; Employee Bene-
{"title":"Defining underinsurance: a conceptual framework for policy and empirical analysis.","authors":"R Bashshur, D G Smith, R A Stiles","doi":"10.1177/107755879305000204","DOIUrl":"https://doi.org/10.1177/107755879305000204","url":null,"abstract":"Much research and policy attention in recent years has been drawn to the plight of the uninsured in the United States-the numbers of people with no health care coverage from any source, their demographics (as well as other characteristics and factors leading to access barriers), and their health status-all under circumstances of escalating costs and seemingly inevitable uncompensated care (Brown 1989; Employee Bene-","PeriodicalId":79684,"journal":{"name":"Medical care review","volume":"50 2","pages":"199-218"},"PeriodicalIF":0.0,"publicationDate":"1993-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/107755879305000204","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21000248","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 : 1993-01-01DOI: 10.1177/002570879305000302
B Stanton, M Berman
{"title":"Professional advancement of social scientists within schools of medicine.","authors":"B Stanton, M Berman","doi":"10.1177/002570879305000302","DOIUrl":"https://doi.org/10.1177/002570879305000302","url":null,"abstract":"","PeriodicalId":79684,"journal":{"name":"Medical care review","volume":"50 3","pages":"259-70"},"PeriodicalIF":0.0,"publicationDate":"1993-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/002570879305000302","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21001772","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 : 1993-01-01DOI: 10.1177/002570879305000303
W R Scott
{"title":"The organization of medical care services: toward an integrated theoretical model.","authors":"W R Scott","doi":"10.1177/002570879305000303","DOIUrl":"https://doi.org/10.1177/002570879305000303","url":null,"abstract":"","PeriodicalId":79684,"journal":{"name":"Medical care review","volume":"50 3","pages":"271-303"},"PeriodicalIF":0.0,"publicationDate":"1993-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/002570879305000303","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21001773","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 : 1993-01-01DOI: 10.1177/107755879305000202
S E Feldman, T G Rundall
Sanford E. Feldman, M.D. is on the surgical faculty, Mt. Zion Medical Center, University of California, San Francisco. Thomas G. Rundall, Ph.D. is Professor of Health Policy and Administration in the School of Public Health, University of California, Berkeley. Address correspondence and requests for reprints to Dr. Feldman at 78 Coronet Avenue, Mill Valley, CA 94941. This article, submitted to Medical Care Review on December 1, 1992, was reviewed and accepted for publication on January 4, 1993.
{"title":"PROs and the health care quality improvement initiative: insights from 50 cases of serious medical mistakes.","authors":"S E Feldman, T G Rundall","doi":"10.1177/107755879305000202","DOIUrl":"https://doi.org/10.1177/107755879305000202","url":null,"abstract":"Sanford E. Feldman, M.D. is on the surgical faculty, Mt. Zion Medical Center, University of California, San Francisco. Thomas G. Rundall, Ph.D. is Professor of Health Policy and Administration in the School of Public Health, University of California, Berkeley. Address correspondence and requests for reprints to Dr. Feldman at 78 Coronet Avenue, Mill Valley, CA 94941. This article, submitted to Medical Care Review on December 1, 1992, was reviewed and accepted for publication on January 4, 1993.","PeriodicalId":79684,"journal":{"name":"Medical care review","volume":"50 2","pages":"123-52"},"PeriodicalIF":0.0,"publicationDate":"1993-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/107755879305000202","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21000246","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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