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PubMed2002

Pharmaceutical industry research and cost savings in community-acquired pneumonia.

OBJECTIVE: To provide financial justification for continuing pharmaceutical research in an environment that has met with increasing resistance from insurance carriers to paying for the care of patients enrolled in research studies. STUDY DESIGN: Matched case-control study of patients enrolled into inpatient community-acquired pneumonia (CAP) pharmaceutical research protocols. PATIENTS AND METHODS: Case patients were enrolled into a CAP pharmaceutical research trial. Control patients were obtained from a prospective cohort study of CAP. Cases were matched to controls on the basis of age, sex, pneumonia severity index (PSI) grade, and comorbid illnesses as measured by the PSI and Acute Physiologic and Chronic Health Evaluation II (APACHE II) scoring systems. Financial data were obtained from hospital billing records. RESULTS: Twenty-five cases were identified and matched to appropriate controls. There was no statistically significant difference in mean PSI and APACHE II scores between cases and controls. There was a significant reduction in the total charges for hospital care of patients enrolled into a pharmaceutical industry trial ($6267 vs $9979; P = .03). As expected, the most dramatic reduction was in pharmacy charges ($642 vs $1797; P = .002), but there were trends toward lower charges in all cost subgroups. Interestingly, there was also a strong trend toward reduced length of hospital stay associated with enrollment in a pharmaceutical trial (4.5 vs 6.0 days; P = .06). CONCLUSION: Enrollment in a pharmaceutical research protocol results in significant cost savings in patients admitted to the hospital with CAP and may lead to earlier hospital discharge.

4-Quinolones↗
PubMedDate not supplied

Professional liability insurance rates--some history & solutions.

The medical malpractice business, as with the property and casualty industry as a whole, is cyclical in nature. We have experienced peaks and valleys since the mid-1970s. History would tell us that profitability can be restored in time. Many in the professional liability insurance industry think that a return to stability is possible by 2004. The two most critical factors in restoring this profitability may be adequate pricing and tort reform--time will tell the story.

Humans↗
PubMed2003

Health insurance reform: modifications to electronic data transaction standards and code sets. Final rule.

In this final rule, we respond to public comments received and finalize provisions applicable to electronic data transaction standards from two related proposed rules published in the May 31, 2002, Federal Register. We are also adopting proposed modifications to implementation specifications for health care entities and others. In addition, we are adopting modifications to implementation specifications for several electronic transaction standards that were omitted from the May 31, 2002, proposed rules.

Confidentiality↗
PubMed2003

Pitching plans to the uninsured. Insurers increasingly see viable market in growing pool of middle-class workers who don't have health insurance.

It's a bold new world in healthcare insurance. A few years ago, insurers would have been reluctant to use advertising dollars to reach the uninsured. But now, as the average income of the typical uninsured person is climbing and Congress is pondering initiatives to expand coverage, the market is gaining zealous suitors. "Things are really heating up," says Merrill Matthews Jr., left, director of the Council for Affordable Health Insurance.

Advertising↗
PubMed2003

Mergers and health care organizations.

The concerns over ever-rising health care costs has motivated physicians, hospitals, and insurance carriers to search for ways to increase efficiency, decrease costs, and maintain or improve quality. Mergers have been recognized as having the capability to accomplish all three goals-but not without some concerns. This article's intent is to provide the reader with basic knowledge that will assist in understanding the discussion regarding the appropriateness of mergers in health care. It reviews issues raised by mergers and examines a few case studies of merged health care organizations.

Antitrust Laws↗