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Biomedical subjects

T Hongsermeier

Publications and source records attributed to T Hongsermeier.

7 recordsLinked to original sources
PubMed1997

Solution to patient access to specialist care lies in a balanced approach.

Managed care economic and administrative measures designed to coerce "gatekeepers" to limit patients' access to specialist care need to be balanced by sound clinical protocols. Balance is maintained when appropriateness of care, not costs, guides care and referral decisions. This article explores how appropriateness can be achieved through the use of clinical decision support criteria or guidelines. Not only do the guidelines enable providers to deflect demand appropriately and prevent unnecessary interventions, they help mitigate the financial risk that providers assume under managed care.

Clinical Protocols↗
PubMedDate not supplied

Evaluation of a practical technique for determining insulin requirements in diabetic patients receiving total parenteral nutrition.

A practical technique to provide central parenteral nutrition to insulin-taking diabetic patients based on prehospitalization insulin requirements and insulin placed in the central parenteral nutrition was originally presented based on retrospective review. The present article confirms the safety and applicability of this method after a multiyear period of application. Particularly noteworthy are the absence of hypoglycemic episodes, the attainment of reasonable blood glucose control, and the relatively consistent relationship of insulin required in central parenteral nutrition to prehospitalization insulin requirements.

Algorithms↗
PubMedDate not supplied

Managing the interface between primary-care provider and specialist.

Confusion abounds regarding what constitutes a minimum standard of primary-care management and when it is appropriate to refer. Regardless of the cost-containment methods employed, financial-incentive models applied in the absence of clinical appropriateness criteria may result in implicit rationing of healthcare services. Software-embedded clinical criteria are essential in these changing times.

Capitation Fee↗
PubMedDate not supplied

Managing resources. Directing patients to appropriate specialist care.

Patients and physicians are wary that managed care will unnecessarily limit access to specialists. At the same time, there is a recognized need to control medical costs. Clinical decision support criteria can help group practices achieve balance between clinical protocol and cost management. They help protect against over- and underutilization of resources, including specialist care. They also help physicians justify care decisions to the patient and to the health plan providing payment.

Cost Control↗