Managed care

Ultimately, guidelines such as those above will be taken seriously only if production management carefully configures the alarms. The consequences of excessive and redundant alarms will be felt primarily by those responsible for produc tion operations. Therefore, production management must make adequate resources available for reviewing and analyzing the proposed alarm configurations. 

MANAGING CARE OF THE OUTPATIENT. At the time of each visit of the patient to the primary health care provider s office or clinic, the nurse observes the patient for a response to therapy. In some instances, the nurse may question the patient or a family member about the response to therapy. The questions asked depend on the patient and the diagnosis and may include questions such as... 

Mills P, Michnich M. Managed care and cardiac pacing and electrophysiology. Pacing Clin Electrophysiol 1993 16 1746-50. 

Quenzer RW, Pettit KG, Arnold RJ, Kaniecki DJ. Pharmacoeconomic analysis of selected antibiotics in lower respiratory tract infection. Am J Manag Care 1997 3 1027-36. 

Managed care origins, principles and evolution. BrMedj3, 1823—6. 

Palmer CS, Revicld DA, Genduso LA, et al (1998). A cost-effectiveness clinical decision analysis model for schizophrenia. Am J Managed Care 4, 345-55. 

Edgell ET, Hylan TR (1997). Economic outcomes associated with initial treatment choice in depression a retrospective database analysis. Am J Managed Care 5, S51. 

The interaction between ammonia in an aqueous solution and oxide is very exothermic and has to be managed carefully. If ammonia is in the gaseous state, the exothermicity of the interaction causes incandescence of the oxide, causing serious accidents. 

Perfetto EM, Gondek EK. Escherichia coli resistance in uncomplicated urinary tract infection a model for determining when to change first-line empirical antibiotic choice. Manag Care Interface 2002 6 35M2. 

C. N. Swenson and G. Fundale, Observational cohort study of switching warfarin sodium products in a managed care organization, Am J. Health Syst. Pharm, 57, 452 (2000). 

Generic drug product equivalence current status, Am. J. Manag. Care, 4, 1183 (1998). 

Managed care links the financing or insurance aspect of health care with the provision of health care goods and services, and organizations with this type of linkage have been in existence for a long time. In 1933, a physician and an insurance agent devised a health care plan where the physician was paid 0.05 per worker per day to provide work-related health care to workers... 

Fig. 1 Health maintenance organization enrollment in the United States. (From Hoechst Marion Roussel Managed Care Digest Series /HMO-PPO Digest 1999.)...

To better understand managed care and the reasons for its growth, it is useful to discuss the evolution of payment mechanisms for health care from no insurance, to traditional indemnity insurance, to managed care. In the no-insurance model, the patient selects a health care provider and then pays the provider directly for health care goods and services. The choice of health care provider and the type and number of services provided are limited only by the financial constraints of the patient. The problem with this model is that the patient is exposed to potentially catastrophic health care expenses. Health insurance was developed as a way to protect patients against this risk. Health insurance often is provided through the employer and prior to the mid-1980s was likely to be indemnity fee-for-service insurance. In this traditional insurance... 

Both primary care physicians and specialists may be paid via capitation arrangements, but the arrangement is more common for primary care physicians. In one survey of managed care organizations, 37% used capitation as the main method of... 

Health maintenance organizations are the most restrictive type of managed care organization, and consumer dissatisfaction with restricted choice in HMOs likely was a significant factor in the growth of point of service (POS) plans. POS plans sometimes are referred to as open-ended HMOs. Like HMOs, enrollees typically select a primary care provider and pay no fee or a small copayment to see participating providers. POS plans differ from HMOs in that patients can receive coverage from physicians outside the network. However, patients pay more for care received from physicians outside the network and often must pay the full... 

A deductible is a fixed amount (e.g., 100) that the patient must pay before the managed care plan pays for their prescription drugs. Deductibles often are used... 

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