Collaboration Among Competing Managed Care Organizations for Quality Improvement


Book Description

In November, 1997, The Institute of Medicine convened a one-day conference to explore areas for potential collaboration to improve quality among competing health plans consistent with antitrust and other legal requirements. The conference was convened to clarify the limits of such potential activities and to explore ways to stimulate collaboration; in short, to explore permissible and promising areas for collaboration for competing health plans. Competition has existed at the provider level in the pre-managed care era and continues among physicians, physician groups and hospitals today. What is new is the extent of competition at the managed care organization level in individual regional markets. As large numbers of individuals are enrolled in health plans, the potential for new forms of cooperation for improving quality of care becomes possible. Along with these new possibilities, however, come questions about whether they bring the potential for antitrust violation.







Managing Care: A Shared Responsibility


Book Description

This book traces the growth of managed care as a mechanism for curbing excessive growth in health costs, and the controversies that have risen around for-profit health care. Also examined are decentralization in US health care, and the absence of comprehensive health care planning, access rules, and minimum health care benefit standards. Finally, the author proposes a framework for improving access to quality, affordable health care in a competitive market environment.




Encyclopedia of Health Services Research


Book Description

Today, as never before, healthcare has the ability to enhance the quality and duration of life. At the same time, healthcare has become so costly that it can easily bankrupt governments and impoverish individuals and families. Health services research is a highly multidisciplinary field, including such areas as health administration, health economics, medical sociology, medicine, , political science, public health, and public policy. The Encyclopedia of Health Services Research is the first single reference source to capture the diversity and complexity of the field. With more than 400 entries, these two volumes investigate the relationship between the factors of cost, quality, and access to healthcare and their impact upon medical outcomes such as death, disability, disease, discomfort, and dissatisfaction with care. Key Features Examines the growing healthcare crisis facing the United States Encompasses the structure, process, and outcomes of healthcare Aims to improve the equity, efficiency, effectiveness, and safety of healthcare by influencing and developing public policies Describes healthcare systems and issues from around the globe Key Themes Access to Care Accreditation, Associations, Foundations, and Research Organizations Biographies of Current and Past Leaders Cost of Care, Economics, Finance, and Payment Mechanisms Disease, Disability, Health, and Health Behavior Government and International Healthcare Organizations Health Insurance Health Professionals and Healthcare Organizations Health Services Research Laws, Regulations, and Ethics Measurement; Data Sources and Coding; and Research Methods Outcomes of Care Policy Issues, Healthcare Reform, and International Comparisons Public Health Quality and Safety of Care Special and Vulnerable Groups The Encyclopedia is designed to be an introduction to the various topics of health services research for an audience including undergraduate students, graduate students, andgeneral readers seeking non-technical descriptions of the field and its practices. It is also useful for healthcare practitioners wishing to stay abreast of the changes and updates in the field.




LEADING AND MANAGING PEOPLE IN HEALTHCARE ORGANISATIONS


Book Description

The aim of this article is to urge caregivers to improve how they work and communicate among themselves during service delivery to their service users. Therefore, it is recommended that every healthcare provider viably cooperate to enhance standard of care to vulnerable people (such as allowing care decision making, dignity and patients' involvement). Subjects: Healthcare organisations, care homes, hospitals, leadership and management, person centred care, childhood obesity, discrimination and inclusion in the workplace, collaborative working, organisational culture and service improvement.




To Err Is Human


Book Description

Experts estimate that as many as 98,000 people die in any given year from medical errors that occur in hospitals. That's more than die from motor vehicle accidents, breast cancer, or AIDSâ€"three causes that receive far more public attention. Indeed, more people die annually from medication errors than from workplace injuries. Add the financial cost to the human tragedy, and medical error easily rises to the top ranks of urgent, widespread public problems. To Err Is Human breaks the silence that has surrounded medical errors and their consequenceâ€"but not by pointing fingers at caring health care professionals who make honest mistakes. After all, to err is human. Instead, this book sets forth a national agendaâ€"with state and local implicationsâ€"for reducing medical errors and improving patient safety through the design of a safer health system. This volume reveals the often startling statistics of medical error and the disparity between the incidence of error and public perception of it, given many patients' expectations that the medical profession always performs perfectly. A careful examination is made of how the surrounding forces of legislation, regulation, and market activity influence the quality of care provided by health care organizations and then looks at their handling of medical mistakes. Using a detailed case study, the book reviews the current understanding of why these mistakes happen. A key theme is that legitimate liability concerns discourage reporting of errorsâ€"which begs the question, "How can we learn from our mistakes?" Balancing regulatory versus market-based initiatives and public versus private efforts, the Institute of Medicine presents wide-ranging recommendations for improving patient safety, in the areas of leadership, improved data collection and analysis, and development of effective systems at the level of direct patient care. To Err Is Human asserts that the problem is not bad people in health careâ€"it is that good people are working in bad systems that need to be made safer. Comprehensive and straightforward, this book offers a clear prescription for raising the level of patient safety in American health care. It also explains how patients themselves can influence the quality of care that they receive once they check into the hospital. This book will be vitally important to federal, state, and local health policy makers and regulators, health professional licensing officials, hospital administrators, medical educators and students, health caregivers, health journalists, patient advocatesâ€"as well as patients themselves. First in a series of publications from the Quality of Health Care in America, a project initiated by the Institute of Medicine




The Internet and Health Communication


Book Description

With the popularity of the Internet, more and more people are turning to their computers for health information, advice, support and services. With its information based firmly on research, The Internet and Health Communication provides an in-depth analysis of the changes in human communication and health care resulting from the Internet revolution. Representing a wide range of expertise, the contributors provide an extensive variety of examples from the micro to the macro, including information about HMO web sites, Internet pharmacies, and web-enabled hospitals, to vividly illustrate their findings and conclusions.







Managed Care Quality


Book Description

Managed care organizations are paving the way to the future of health care delivery in the United States and countries around the world. As managed care systems evolve, a major concern is quality. Managed Care Quality: A Practical Guide is a collection of applications and experiences gathered from practicing health professionals in the field of managed care. This first "how to" guide was written to help managed care organizations meet the common objective of ensuring the best quality of services and care. Managed Care Quality: A Practical Guide presents successive steps in implementing quality in health care organizations. It introduces the methods, skills, and practices involved in quality health care programs and offers solutions to problems typically encountered in managed care.




Collaboration Across the Disciplines in Health Care


Book Description

Bringing together seasoned professionals from many disciplines of medicine, this timely resource helps readers develop communication skills and prepares them to work inter-professionally with those who have different perspectives and thought processes.