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At least 73 records · Page 4Linked to original sources
PubMed1989

In-depth analysis of anesthetic mishaps: tools and techniques.

In-depth analysis of an anesthetic mishap requires the acquisition and analysis of a complex body of data. These tasks are facilitated by specific tools and approaches. At the outset, the reviewer should create a registry for documents and seek a factual overview of events. Basic information about case management should be obtained with a structured survey instrument. Critical pieces of information must be explicitly indexed for later examination. Timelines are particularly effective for organizing and displaying key events. The process of data analysis can be expedited by starting with broad concerns and moving to finer distinctions in a stepwise manner. Preparation of a short summary is the first analytic task. Next, the relationships between the injury, the mechanism of injury, and the contributory actions of the caretakers are formally linked as a hypothesis of injury. Finally, each contributory action is examined individually to determine if it represents a deviation from the standard of care. Contradictory information is an expected feature of in-depth analysis. This problem can often be resolved by testing for clinical relevance, identifying obvious inaccuracies, and emphasizing findings from the most reliable sources. Recent work suggests that practicing anesthesiologists can analyze mishaps with a significant degree of interrater reliability. Thus, aggregate data obtained from in-depth analysis may play an increasingly important role in research, risk management, and peer review.

Anesthesiology↗
PubMed1995

Managed care liability and the capitated provider.

While there have been no reported cases as yet on the subject of ERISA preemption of claims arising from utilization review decisions by providers, it will unquestionably be a significant issue facing providers that participate in capitated arrangements. If preemption is determined not to be available, providers will be exposed to risks from which health plans are currently shielded. Providers conducting utilization review should be following this issue as it develops, but should also be obtaining insurance for this risk to the extent it is available (e.g., it will not be available for punitive damages). Providers should also consider negotiating provisions in their contracts with health plans to the effect that any utilization review conducted by the provider is on behalf of the health plan and that the provider's utilization review activities will be covered under the health plan's liability insurance.

Capitation Fee↗
PubMedDate not supplied

Increased physician disability claims causing 'crisis'. High utilization of disability insurance may leave physician groups fewer options in the future.

With physician claims on the rise, disability insurers are adjusting rates, provisions and benefit plans that are offered to those in the medical field. Physicians are being hit the hardest, experiencing premium increases, benefit reductions and stricter qualifications for coverage. There are only a few carriers who have not changed their rate structures and benefit plans. Now is the time to review the quality of your disability programs and establish how your carrier is reacting to this trend.

Disability Evaluation↗