In-Hospital Patient Care
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The term, managed care, refers to physician management. Managed care plans are based on entire networks of health care providers. For the most part, recent changes within the health care industry have favored managed care facilities. These organizations are able to dispense high-quality, cost-effective services. Hospital expenses are typically increased by such factors as unnecessary hospital days, adverse events, and hospital readmissions. However, prospective payment systems, capitated agreements, retrospective denial of payment, and other reforms may increase hospitals' fiscal responsibilities. Managed care facilities must therefore find ways to improve operations and minimize health care costs. One possible means by which expenditures might be reduced involves primary care. In many managed care hospitals, in-hospital physicians attend to patients' medical needs. Furthermore, these providers are able make sure that health care resources are utilized efficiently. Miller and Luft (1994) compares managed care plans and indemnity plans. The term "managed care plan" may describe any plan employing an organized group of providers. Typically, a health benefit intermediary contracts with an employer or the government to provide health care to its employees (Miller & Luft, 1994, pp. 1512-1518). According to the Health Maintenance Organization Act of 1973, many employers are required to provide such benefits. This intermediary can be either a health maintenance org
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man, 1994, pp. 78-81).
Other ways that in-hospital physician care may be assessed include length of stay, return to surgery, and readmission analyses. Patients' length of stay in the hospital is sometimes used as a measure of resource utilization (Lee et al., 1995, 434-437). Longer stays obviously increase health care costs. Massad et al. (1993) examined correlates of length of stay in gynecologic oncology patients. The study concluded that the "determinants of length of stay are multiple"; furthermore, the authors found that "no single factor" accounted for length of stay in a cohort of women treated surgically for gynecologic cancer (Massad et al., 1993, pp. 214-217).
In recent years, significant effort has been focused on reducing unnecessary hospital days. The various assessments are typically accomplished through utilization review efforts. These compare either hospital medical staffs or groups within the medical staff with published data. Baigelman et al. (1994) attempted to identify specific medical staff subgroups which were most responsible for unnecessary hospital days. The study found that 20 percent of the unnecessary days were caused by problems in discharge planning. This concurred with Selker et al. (c
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According Andrulis, Physician-employees HMO, Burns Wholey, Corrigan Martin, Lonsdale Hutchison, , Miller Luft, Surveys HMOs, Organization Act, Increasingly HMOs, et al, health care, primary care, managed care, 1994 pp, length stay, al 1994, et al 1994, care plans, bindman 1994, baigelman et al, hospital days, corrigan martin 1992, burns wholey 1991, miller luft 1994,
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Approximate Pages = 11 (250 words per page)
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