Changing Health Care Systems and Rheumatic Disease / Edition 1

Changing Health Care Systems and Rheumatic Disease / Edition 1

by Frederick J. Manning, Jeremiah A. Barondess, Committee on Changing Health Care Systems and Rheumatic Disease, Institute of Medicine
     
 

ISBN-10: 0309056837

ISBN-13: 9780309056830

Pub. Date: 01/03/1997

Publisher: National Academies Press

Market forces are driving a radical restructuring of health care delivery in the United States. At the same time, more and more people are living comparatively long lives with a variety of severe chronic health conditions. Many such people are concerned about the trend toward the creation of managed care systems because their need for frequent, often complex,

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Overview

Market forces are driving a radical restructuring of health care delivery in the United States. At the same time, more and more people are living comparatively long lives with a variety of severe chronic health conditions. Many such people are concerned about the trend toward the creation of managed care systems because their need for frequent, often complex, medical services conflicts with managed care's desires to contain costs. The fear is that people with serious chronic disorders will be excluded from or underserved by the integrated health care delivery networks now emerging. Responding to a request from the National Institute of Arthritis and Musculoskeletal and Skin Diseases, this book reflects the results of a workshop that focused on the following questions:

  • Does the model of managed care or an integrated delivery system influence the types of interventions provided to patients with chronic conditions and the clinical and health status outcomes resulting from those interventions?
  • If so, are these effects quantitatively and clinically significant, as compared to the effects that other variables (e.g., income, education, ethnicity) have on patient outcomes?
  • If the type of health care delivery system appears to be related to patient care and outcomes, can specific organizational, financial, or other variables be identified that account for the relationships?
  • If not, what type of research should be pursued to provide the information needed about the relationship between types of health care systems and the processes and outcomes of care provided to people with serious chronic conditions?

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Product Details

ISBN-13:
9780309056830
Publisher:
National Academies Press
Publication date:
01/03/1997
Edition description:
New Edition
Pages:
256
Product dimensions:
6.00(w) x 9.00(h) x (d)

Table of Contents

1Introduction1
2Opening Remarks17
3Keynote Address21
4What Would Ideal Care Look Like?31
5Managed Care and Rheumatoid Arthritis: Utilization and Outcomes Over 11 Years73
6Measuring Medical Outcomes: Longitudinal Data on the Differential Impact of Health Care Systems on Chronic Diseases95
7Changing Health Care Systems and Access to Care for the Chronically Ill115
8Training and Utilization of Generalists and Subspecialists at the University of California, Los Angeles147
9How Easily Do Health Care Systems Adopt New Knowledge, and What Are the Likely Future Developments169
10Issues and Insights Regarding Research, Education, and Training189
11Commentary on the Day's Papers209
12Conclusions and Recommendations213
App. ABiographies of Committee Members and Speakers223
App. BWorkshop Guests239

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