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At least 73 records · Page 4Linked to original sources
PubMed1983

Medicare program; hospital insurance entitlement and benefits--Health Care Financing Administration, Final rule.

These regulations implement thirteen legislative amendments concerning (1) entitlement of aged or disabled persons to Medicare, (2) requirements for receiving posthospital skilled nursing facility care and home health services, (3) determination of the deductible and coinsurance amounts for which a beneficiary is responsible, and (4) enrollment of individuals who must pay a monthly premium for Medicare. They also clarify, reorganize and renumber a major portion of our existing Medicare regulations.

Aged↗
PubMed1991

[Meaning of the "scientific validity clause" of private hospital insurance (section 5/1 f MB/KK 76). With reference to recent verdicts].

As per Section 5/1 f of the classic conditions 1976 of the "Association of private health insurance carriers" (Verband der privaten Krankenversicherung), benefits won't be paid for methods of examination or treatment and remedies which are from the scientific point of view generally not recognized. Basic reflections have led to the fact that today the term "scientifically recognized methods" and the term "traditional medicine" will be treated as equivalent. Contrary verdicts, according to which treatments on the basis of anthroposophic medicine or by means of electro-acupuncture by Voll would be considered as generally recognized medicine from the scientific point of view and would have to be paid by the private health insurance carriers, are consequently not comprehensible. Supposing that the trend continues that private health insurers have to pay more and more expenses incurred for all kind of outsider-methods, this would lead not only to a great drain on the purse of the private health insurance carriers, but have also unpleasant consequences for the whole medicine, because the uniformity of the medicine is endangered. To take steps against has not only to be the task of the private health insurance carriers, but it is also in the interest of the physicians and, at last, of the patients, too.

Complementary Therapies↗
PubMed1996

[Results of expert assessment of disability with reference to selected diagnostic groups by the Medical Service of Hospital Insurance].

A topical survey is given by the documentation of the examination for the statutory nursing care insurance. The first part of the report contains the complete tabulated results of the Federal Republic of Germany. Furthermore a graphical comparison of selected groups of diagnoses like psychiatric disorders has been statistically evaluated and is commented upon.

Adult↗
PubMed1998

[Recommendation for rehabilitation measures of elderly disabled patients by the medical service of hospital insurance in Berlin and Brandenburg].

According to the German Nursing Care insurance law (Pflegeversicherungsgesetz) experts of the Medical Advisory Board of the statutory sickness funds (Medizinischer Dienst der Krankenversicherung, MDK) must consider recommending rehabilitative measures for persons in need of nursing care. This study measures the proportion of proposed rehabilitative therapies (physiotherapy, ergotherapy, speech therapy) as well as clinical and non-clinical predictors for these recommendations. The study population of the cross-sectional study consisted of all persons aged 60 years and older in Berlin and Brandenburg for whom the MDK experts had diagnosed a need for nursing care (stages I to III) by means of home visits in the second half of 1995. Data on recommendations and potential predictors were taken from the expert records. Recommendation rates were 6.6% (physiotherapy), 0.7% (ergotherapy) and 0.8% (speech therapy) respectively, for Berlin and Brandenburg taken together. While clinical variables (impairments and disabilities) had a considerable impact on the recommendations, also non-clinical variations were noted. Physiotherapy recommendation rates differed 3-fold by region (Brandenburg: 10.3%; Berlin: 3.4%). Variations also existed for age (60-70 years: 10.7%; > 90 years: 2.5%) and the presence of a professional care institution (present: 8.6%; not present: 5.4%). The strongest effect had an already existing prescription of physiotherapy from the patient's physician (current physiotherapy: 23.5%, no current physiotherapy: 4.6%). Multiple logistic regression demonstrated that these variables had independent effects after accounting for their overlapping influences and clinical characteristics. Variations of physiotherapy recommendation rates were also found for profession of the MDK experts (physician: 5.9%; nurse: 9.2%; physician and nurse together: 7%), but the effects were only partially independent. The observed low rates of recommended physiotherapy, ergotherapy and speech therapy as well as the non-clinical variations question the appropriateness of current recommendation practices.

Aged↗
PubMed1997

The effect of type of hospital and health insurance on hospital length of stay in Irbid, North Jordan.

The study aimed at examining the effects of type of hospital and health insurance status on hospital length of stay for three identified medical and surgical conditions. Medical records of 520 patients for the year 1991 were reviewed in one public and one private hospital. Comparison of hospital length of stay for the private (n = 185) versus public sector patients (n = 335) was carried out. The effect of presence of health insurance (n = 189) and the lack of it (n = 325) was also studied. It was found that the average length of stay in the public hospital was significantly longer than the private one (3.3 versus 2.7 days). In addition, insured patients had significantly longer hospital length of stay (3.3 versus 3.0 days). The results of the multi-variate analysis showed that after socioeconomic factors and clinical conditions of patients were adjusted for, the influence of hospital type and health insurance on hospital length of stay was about one day. The paper also discusses the need to base hospital cost-containment strategies on studies of hospital behaviour and performance.

Adolescent↗
PubMed1978

Hospital-sponsored groups offer viable malpractice insurance.

Hospital - sponsored insurance organizations can offer their members many advantages, especially reasonable and stable malpractice insurance coverage and premium rates. To do so, they must ensure their financial stability through the support of the insured and through adequate reinsurance, compete effectively with commercial insurance companies, comply with federal regulations regarding reimbursement to hospitals for premiums, and develop effective internal management.

Bermuda↗