Managed care basic concepts

The basic concept of prehospital care and patient transfer is carrying the patient to a facility capable of rapid revascularization, if fibrinolysis therapy is contraindicated. If the patient cannot be transferred to the facility capable of prompt intervention, fibrinolytic therapy is strongly recommended to start within 90 minutes of first medical contact. After such treatment, medical therapy will become important in managing the patient. 

The basic concepts of managed care have evolved and are continuing to evolve over time. To understand this evolution, a brief historical perspective is presented first, followed by discussions of the language and principles of managed care. 

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