EFFECTS OF MANAGED CARE ON SURGICAL CARE
Managed care programs are increasing in number with the goals of controlling health care costs and continuing to provide quality care. Questions exist, however, regarding the maintenance of the quality of care provided to patients under a managed care regime. This study examines the effects of managed care on surgical care.
Assessing the quality of care provided to patients is the essential foundation for improving care (Gagel, 1995). With respect to managed care regimes, assessments of the quality of care delivered to patients under such regimes are mixed. Measures include process and outcomes criteria. At a general level, the quality of care is generally found to be comparable in managed care and fee-for-service settings. Evidence shows that managed care patients tend to receive more preventive tests, procedures, and examinations than those in fee-for-service settings. Outpatient care satisfaction, however, tends to be rated lower in managed care settings. Care provided in inpatient settings is an area of increasingly frequent and harsh criticisms of managed care. Under a managed care regime, capitation, copayments, and deductibles limit the use of services, particularly in relation to inpatient hospital care (Quickel, 1996).
Surgical care occurs in both outpatient settings (where patient satisfaction is lower under managed care than under fee-for-service regimes) and inpatient settings (where managed care is the target of increasingly frequent and harsh criticisms). The effects of managed care on surgical care, thus, is a problem of current interest that merits investigation. This problem is investigated in this study.
The purpose of this study is to conduct an extensive survey of relevant literature to identify and examine the effects of managed care on the quality of surgical care provided to patients. The objective is to identify such effects in both contemporary an...