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At least 811 records · Page 45Linked to original sources
PubMed1996

The use of personal health information for controlling the costs of delivering health care: does the end justify the means?

With the increasing costs of medical care many countries are seeking ways of controlling costs. Two approaches are discussed; the accounting control of costs and the medicalised control of costs. The former provides a very blunt and insensitive instrument while the latter can support best practice and reduce unnecessary examinations. However, the medicalised approach requires limited access to the patients' medical files thus breaching the medical secret. The paper discusses the strict controls necessary to make this approach work in an acceptable fashion.

Computer Security↗
PubMed2001

[Managed care, control of costs and the patient's health].

The following article aims at reviewing the main historical evolutions of the Managed Care in the United States of America. We will also try to gain a better understanding of the main ethical issues raised by the physicians in the Managed Care context. Those issues have raised important concerns among the population of physicians. Furthermore, we will try to describe some of the mechanisms that have been developed by the HMOs to reduce the costs of care in the U.S.A. Finally, we will see the side-effects of the measures that have been decided to reduce the cost of care and how they affect the quality of care delivered to patients.

Cost Control↗
PubMed2000

Newcastle disease: outbreak losses and control policy costs.

The costs of controlling and eradicating the epidemic of Newcastle disease in Northern Ireland in 1973 are presented. The parameters of the 1973 epidemic have been adjusted to simulate the effect of the same epidemic in 1997, taking into account the relative changes of input and output prices, and the changes in the structure of the poultry industry. The costs and their distribution between producers, government and the industry, in 1973 and 1997 are compared, and the costs of an alternative vaccination strategy are compared with the eradication policy in both years.

Animals↗
PubMed2004

Failure of Medicare health maintenance organizations to control the cost of colon resections in elderly patients.

HYPOTHESIS: Medicare health maintenance organizations (HMOs) do not reduce the cost of colon resections in elderly patients. DESIGN: Review of prospectively collected and mandatory reported Florida hospital discharge data from January 1, 1995, through December 31, 1999. We used the chi(2) test for trend analysis to assess significant change in age, mortality, and complications, and the Kruskal-Wallis test to compare inflation-adjusted hospital charges, comorbidity, length of stay, and secondary procedures. SETTING: Administrative database including all community- and university-based surgeons. PATIENTS: All patients 70 years or older who underwent colon resection from 1995 through 1999. MAIN OUTCOME MEASURES: Age, mortality, complications, length of stay, number of comorbidities and secondary procedures, hospital charges, and type of colon resection. RESULTS: The frequency of different colon resections increased by 10% to 30% from 1995 through 1999. Total hospital charges increased during the study period (P<.001), whereas mortality and complications remained unchanged. Length of stay, number of secondary procedures, and comorbidities were the most significant contributors to hospital charges. Despite a significantly shorter hospital stay, Medicare HMO patients had similar hospital charges to those of original Medicare patients. CONCLUSIONS: Colon resections can be undertaken in elderly patients with acceptable morbidity. Per diem charges were higher for patients covered by Medicare HMO, despite their having shorter lengths of stay, fewer comorbidities, and fewer secondary procedures.

Aged↗
PubMedDate not supplied

Use of anesthesia selection in controlling surgery costs in an HMO hospital.

The cost of induction and maintenance of anesthesia is analyzed in this article from the perspective of a health maintenance organization's (HMO) chief financial officer. While earlier economic studies tended to focus on the raw cost of anesthesia drugs, our model also includes the cost of the clinical labor involved in administering the drug as well as the fixed costs associated with the facility. Such a model is consistent with the goal of an HMO, which is to provide high-quality health care services to its membership while containing costs. Our model disaggregated the costs associated with anesthesia into cost centers. The costs associated with two anesthesia regimens, propofol and thiopental/isoflurane, were calculated and analyzed via cost-minimization methods. Our data were acquired from a prospective economic trial conducted in university, community, and HMO hospitals. Because institutional pricing policies differ greatly, only the findings at the HMO hospital are presented in this report. Our results suggest that intra-abdominal surgical procedures with a duration of less than 4 hours that use propofol for induction and maintenance of anesthesia reduce the total cost of surgery by $202.71, compared with the costs of using thiopental/isoflurane. Sensitivity analysis maintains the robustness of the conclusions with regard to all major parameters.

Accounting↗
PubMedDate not supplied

Can managed care and competition control Medicare costs?

Medicare+Choice (M+C) was conceived to bring managed care and competitive forces to bear on Medicare. Ultimately, M+C could not thrive under the conditions of the marketplace and the Balanced Budget Act of 1997. Here I review what went wrong and the lessons from the experience, concluding that M+C is a tool, not a strategy. While managed care in a multiple-choice environment may have the potential to generate limited savings, promoting managed care and competition alone will not preempt the need for a debate on Medicare's obligations and how to finance them.

Aged↗