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Dissertations / Theses on the topic 'Managed care plans (Medical care) Australia'

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Published: 4 June 2021

Last updated: 19 February 2022

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1

Mills, David. "The role of goal setting in the diabetes case management of aboriginal and non-aboriginal populations in rural South Australia /." Title page, table of contents and abstract only, 2005. http://web4.library.adelaide.edu.au/theses/09MD/09mdm6571.pdf.

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Thesis (M.D.)--University of Adelaide, Dept. of General Practice, 2005.
Includes publications published as a result of ideas developed in this thesis, inserted at end. "April 2005" Includes bibliographical references (leaves 210-242).

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2

Armbruster, Susanne. "Versorgungsnetzwerke im französischen und deutschen Gesundheitswesen : eine vergleichende Studie unter Berücksichtigung rechts- und gesundheitswissenschaftlicher Aspekte /." Stuttgart : Ibidem-Verl, 2004. http://www.gbv.de/dms/sbb-berlin/46191977X.pdf.

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3

Levy, Elizabeth Giselle. "Therapeutic process in a managed care type setting : the working alliance, pre-treatment characteristics and outcome /." Digital version accessible at:, 1998. http://wwwlib.umi.com/cr/utexas/main.

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Beaubien, Jason Michael. "Effectiveness of recipient restriction programs in medicaid managed care organizations /." View online ; access limited to URI, 2005. http://0-wwwlib.umi.com.helin.uri.edu/dissertations/dlnow/3206244.

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5

Brudevold, Christine. "Assessment of capitated contract medicine arrangements in Hong Kong : an example of financial incentives and managed care in an unregulated environment /." Hong Kong : University of Hong Kong, 1999. http://sunzi.lib.hku.hk/hkuto/record.jsp?B20906791.

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6

Callister, Ronda Roberts. "Examining conflicts across organizational boundaries : managed care--provider interactions /." free to MU campus, to others for purchase, 1996. http://wwwlib.umi.com/cr/mo/fullcit?p9801628.

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7

Lindrooth, Richard C. "Selective contracting, cost sharing, and utilization management : a theoretical and empirical analysis of the market for health care /." Thesis, Connect to this title online; UW restricted, 1998. http://hdl.handle.net/1773/7463.

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8

Bornman, Magda. "Digital media as communication tools for health promotion in managed health care." Pretoria : [s.n.], 2000. http://upetd.up.ac.za/thesis/available/etd-07132006-105048/.

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9

Stein, Bradley D. "Drug and alcohol treatment services among privately insured individuals in managed behavioral health care." Santa Monica, CA : RAND, 2003. http://www.rand.org/publications/RGSD/RGSD170/RGSD170.pdf.

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10

Lei, Xiaoyan. "Public and private transfers essays on transfers to children and parents /." Diss., Restricted to subscribing institutions, 2007. http://proquest.umi.com/pqdweb?did=1467890571&sid=1&Fmt=2&clientId=1564&RQT=309&VName=PQD.

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11

Schiffel, Ottalee. "The usefulness of assurance services related to nonfinancial performance measures in the selection of healthcare insurance providers /." free to MU campus, to others for purchase, 2003. http://wwwlib.umi.com/cr/mo/fullcit?p3115589.

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12

Huesch, Marco D. "Three essays in healthcare economics." Diss., Restricted to subscribing institutions, 2008. http://proquest.umi.com/pqdweb?did=1619406861&sid=2&Fmt=2&clientId=1564&RQT=309&VName=PQD.

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Inkelas, Moira. "Incentives in a specialty care carve-out." Santa Monica, CA : RAND Graduate School, 2001. http://catalog.hathitrust.org/api/volumes/oclc/47357973.html.

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14

Carter-Michaelson, Faith. "An exploratory study of San Bernardino County employees' knowledge about the limitations and provisions of their managed health care plans." CSUSB ScholarWorks, 1999. https://scholarworks.lib.csusb.edu/etd-project/1793.

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15

Wilson, Anne. "Self-employed nurse entrepreneurs expanding the realm of nursing practice: a journey of discovery." Title page, contents and abstract only, 2003. http://thesis.library.adelaide.edu.au/public/adt-SUA20030711.100333.

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Hyera, F. L. M. "Integration of the tuberculosis and human immunodeficiency virus control measures in South Africa during January to December 2000 /." Access to E-Thesis, 2004. http://upetd.up.ac.za/thesis/available/etd-08042005-093243/.

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17

Alex, Theodore P. "An investigation of the impact of HealthChoices managed behavioral healthcare on the Lehigh Valley." Instructions for remote access. Click here to access this electronic resource. Access available to Kutztown University faculty, staff, and students only, 1999. http://www.kutztown.edu/library/services/remote_access.asp.

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Thesis (M.P.A.)--Kutztown University of Pennsylvania, 1999.
Source: Masters Abstracts International, Volume: 45-06, page: 2928. Typescript. Abstract precedes thesis as preliminary leaves iii-iv. Includes bibliographical references 122-127.

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18

Hyera, Francis Leonard Mpotte. "Integration of the tuberculosis and human immunodeficiency virus control measures in South Africa during January to December 2000." Diss., University of Pretoria, 2004. http://hdl.handle.net/2263/26977.

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19

Waterstraat, Frank Riegle Rodney P. "Adapting the quality function deployment model to health plan design." Normal, Ill. Illinois State University, 2001. http://wwwlib.umi.com/cr/ilstu/fullcit?p3064505.

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Thesis (Ph. D.)--Illinois State University, 2001.
Title from title page screen, viewed March 10, 2006. Dissertation Committee: Rodney P. Riegle (chair), J. Christopher Eisele, George Padavil, John H. Bantham, Thomas J. Bierma. Includes bibliographical references (leaves 124-128) and abstract. Also available in print.

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20

Kelly-Shelby, Angela Mastracchio. "The collaboration of nurse practitioners and physicians in long-term care using a case-management model in a managed-care environment." [Pensacola, Fla.] : University of West Florida, 2005. http://purl.fcla.edu/fcla/etd/WFE0000038.

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Carney, Philip Sheridan. "Managed healthcare and integrated delivery systems: A model for getting ahead of the change curve." CSUSB ScholarWorks, 2002. https://scholarworks.lib.csusb.edu/etd-project/2103.

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Managed care became the dominant model for moderating healthcare costs in the 1990's. The later half of this past decade witnessed early signs of a return to escalating premiums. Providers and consumers have reacted negatively to perceptions of health plan micro-management and restriction of choice.

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22

Morgan, Heather. "Dentistry : a new era : the change toward oral wellness, evidence based care and managed care at the turn of the century, with recommendations for dentistry." Thesis, Stellenbosch : Stellenbosch University, 2000. http://hdl.handle.net/10019.1/51673.

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Thesis (MBA)--Stellenbosch University, 2000.
ENGLISH ABSTRACT: This report provides a broad overview of the health industry, and the dental industry in particular, identifying trends and searching for possible solutions to problems posed by these trends. It attempts to offer perspectives of importance to all the stakeholders in health care - the patients, the providers of care and third party payers. The current focus of healthcare industry is not actually the health of the patient. Practitioners (the providers) focus too much on treatment, while insurance companies and governments (the payers) emphasise cost containment. As national health care costs spiral, it is ironic that the main reasons for the dramatic health improvements over the last few decades are improvements in socio-economic factors and changes in lifestyle, rather than better treatment. The willingness of insurers to cover new or improved services has acted as a continuing stimulus to cost-increasing advances in medical technology and in tum to spending growth. Managed care has evolved to attempt to improve resource allocation in health care. Thirdparty private-sector regulators have wrested power from government regulators. Their gain in power relative to private practitioners has shifted the power balance from the supply side to the demand side of health care. By leveraging their power in the use of information technology, the practitioner has been forced into a defensive, reactive stance. Managed care is being implemented by profit-driven third parties that benefit from the cost savings. As health providers are the ones who have to implement the cost-savings; it is proposed that they are the ones who should manage healthcare. The ideal would be a coordinated approach with funders and service providers working toward a common goal. Financial accountability is forcing dental practitioners to evaluate their mode of practice in a critical manner. Promoting health, by educating and evoking behaviour change will create a better world for current and future generations. There is a shift in focus from the health of the individual at all costs, to the health of the population. There should be a special emphasis on the dental health of children for whom prevention offers the most gain in outcome. Evidence-based care evolved from the search for the best care, in terms of quality and price, outcome and process, and attempts to reduce variability and subjectivity in clinical decisions, by using systematic reviews of quality evidence to increase objectivity. Emphasis on improved outcomes provides earlier, more valuable, long-term improvements for a patient, than the later, short-term benefit of a cure. Because most canes and gum disease is preventable, dental health professionals should accentuate health promotion and education of patients. The benefits would be to the advantage of all stakeholders in health. A focus on prevention for children could be the ideal form of dental private practice to instil oral wellness in children.
AFRIKAANSE OPSOMMING: Hierdie verslag is 'n breë oorsig van die gesondsheidsindustrie, en van die tandheelkunde industrie in besonder om tendense te identifiseer en na moontlike oplossing te soek vir probleme wat hieruit mag spruit. Dit poog om perspektiewe aan te bied wat van belang is vir die betrokke rolspelers - die pasiënte, die diensverskaffers en die befondsers. Die huidige fokus van gesondheidsorg is nie eintlik die gesondheid van die pasiënt nie. Die die voorsieners van sorg fokus meestal op behandeling, terwyl versekeringsmaatskappye en die regering (die betalers) fokus op die besnoeing van koste. Terwyl nasionale gesondheidskostes styg, is dit ironies dat die belangrikste redes vir die dramaties verbetering in gesondheid oor die laaste paar dekades eerder verbeteringe in sosioekonomiese faktore en veranderinge in leefwyse is as beter behandeling. Die bereidwilligheid van versekeraars om nuwe en verbeterde dienste te dek, is die oorsaak van die aanhoudende stimulus vir mediese tegnologiese vooruitgang en koste stygings. Bestuurde sorg het ontwikkel om te probeer om bron toewysing in gesondheidsorg te verbeter. Derde party privaatsektor-reguleerders het die mag van regering-reguleerders ontruk. Hul invloed, relatief tot die van privaat praktisyns, het die mags-ewewig verskuif van die voorsienings- na die aanvraagkant van gesondheidsorg. Deur die gebruik van hulle voordeel op die gebied van inligtingstegnologie, het hulle die praktisyn in 'n defensiewe houding gedwing. Bestuurde Gesondheidsorg word beheer deur winsgedrewe derde partye wie baat vind by kostebesparings. Aangesien gesondheidsverskaffers die kostebesparings moet implementeer, word daar aanbeveel dat hulle gesondheidsorg moet bestuur. 'n Gesonde samewerkings ooreenkoms tussen befondsers en diensverskaffers is wenslik. Finansiële verantwoordelikheid dwing tandartse om hulle praktyke krities te evalueer. Daar is 'n fokus verskuiwing vanaf die gesondheid van die individu, ten alle koste, na die gesondheid van die bevolking. Besondere klem behoort geplaas te word op die mondgesondheid van kinders, vir wie voorkoming die meeste baat inhou. Bewys-gebaseerde Gesondheidsorg het ontwikkel uit die soektog na die beste sorg in terme van kwaliteit en koste, uitkoms en proses, en pogings om wisselvalligheid en subjektiwiteit in kliniese besluite te verminder. Klem op beter resultate gee vroeër, meer waardevolle langtermyn verbeteringe vir die pasiënt, as die later kort-termyn voordele van genesing. Omdat tandbederf en tandvleissiektes voorkombaar is, behoort tandheelkundiges die bevordering van mondgesondheid te beklemtoon. Voorkoming by kinders word gesuggereer as die ideale vorm van privaat praktyk om mondgesondheid te bevorder.

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23

Brudevold, Christine. "Assessment of capitated contract medicine arrangements in Hong Kong: an example of financial incentives andmanaged care in an unregulated environment." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 1999. http://hub.hku.hk/bib/B31238130.

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24

Kapp, H. A. (Heronemus Albertus). "The Old Mutual Healthcare Call Centre Project : applying world class manufacturing techniques in a non-production environment." Thesis, Stellenbosch : Stellenbosch University, 2005. http://hdl.handle.net/10019.1/50505.

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Thesis (MBA)--Stellenbosch University, 2005.
ENGLISH ABSTRACT: This thesis researches World Class Manufacturing Techniques (WCMT) and their applicability in a Non-Production Environment such as an inbound call centre in the financial services sector. These WCMT involve a set of innovative techniques and principles, which are applied by foremost manufacturing companies. These techniques however, are not sacred and one always needs to refer back to the objectives of World Class Manufacturing, namely to (a) Eliminate waste, (b) Improve quality, (c) Shorten lead times, (d) Reduce costs, and (e) Improve morale and seek other improvements. The importance lies in attaining the objectives in the context of the necessary manufacturing tasks. Companies applying these techniques demonstrate significant productivity gains, production synergies, reduced rework and more reliable on-time delivery. In the highly competitive global market, these offer a competitive advantage for such companies. A critical and essential element of a company's strategic vision is a clearly defined and healthy competitive advantage. It is imperative that a company's vision is clearly aligned to its business objectives and goals. The WCMT is a tool that aligns the business vision and strategic objectives to realize its competitive advantage. By aligning the vision to its competitive advantage, it is crucial that the company challenge its existing production processes and the way in which it operates. Existing production processes need to be continuously reviewed and adjusted where necessary to sustain the competitive advantage. This paper is a practical example of how a non-production organisation can apply these WCMT to sustain its competitive advantage. The WCMT such as Theory of Constraints (TOC), Just in Time (JIT) and Total Quality Management (TQM) are discussed and applied in the inbound call centre of a medical aid administration company. In a relatively short time span, some remarkable sustainable productivity improvements were achieved. This would imply that these WCMT could be applied in traditional non-production environments.
AFRIKAANSE OPSOMMING: Hierdie navorsings werkstuk ondersoek Wêreld Klas Vervaardigings Tegnieke (WCMT) en die moontlike toepassing daarvan in 'n nie-vervaardigings omgewing, soos 'n inbeldienssentrum in die finansiële dienste sektor. Hierdie WCMT omsluit 'n groep innoverende tegnieke wat huidiglik aangewend en toegepas word in die meeste vervaardigings ondernemings. Hierdie tegnieke is nie beperk nie en verwys altyd terug na die doelstellings van WCMT naamlik (a) Vermindering van afval, (b) Verbetering van kwaliteit, (c) Verkorting van wag periodes, (d) Verlaging van kostes, en (e) Verbeterende personeel moraal en die voortdurende soeke na ander verbeteringe. Die belangrikheid van WCMT lê in die bereiking van hierdie bogenoemde doelwitte binne die konteks van die noodsaaklike vervaardigings metodes. Ondernemings wat hierdie tegnieke toepas vind groot produksiekapasiteit verbeteringe, produksie sinergie, 'n verlaging in die oordoen van foutiewe werk en ondervind ook grotendeels meer gereelde op-tyd aflewering. In die hoogs kompeterende globale mark bied die WCMT die broodnodige mededingende voordeel aan hierdie ondernemings. Die kritieke en belangrike bestanddeel van 'n onderneming se strategie en visie is die onderneming se vermoë om 'n deeglike en gesonde mededingende voordeel bo sy mededingers te hê. Dit is van kardinale belang dat die onderneming se visie behoorlik in lyn is met die onderneming se strategiese doelwitte. Hierdie WCMT is 'n instrument wat die onderneming kan aanwend ten einde sy visie en strategiese doelwitte, asook sy kompeterende voordeel, te bereik. Dit is krities belangrik dat 'n onderneming se visie en sy kompeterende doelwitte gesinkroniseer en gelykgestel is en verder dat die onderneming ook sy huidige produksie prosesse herevalueer, asook die manier waarop die onderneming opereer. Huidige produksie prosesse moet voortdurend geherevalueer en aangepas word waar nodig, ten einde die onderneming se voortdurende kompeterende voordeel te behou. Hierdie navorsings stuk is 'n voorbeeld van die praktiese toepassing van WGMT en hoe hierdie tegnieke 'n onderneming behulpsaam kan wees ten einde sy kompeterende voordeel te behou. Die WGMT soos die Teorie van Beperkings (TOC), Net Betyds (JIT) en Totale Kwaliteit Beheer (TQM) word deeglik ondersoek en bespreek. Die navorser ondersoek voorts die moontlikheid om hierdie tegnieke toe te pas in 'n in beldienssentrum by 'n administrateur van mediese fondse. In 'n relatiewe kort periode het die navorser noemenswaardige en voortdurende produksie verbetering teweeg gebring deur die toepassing van WGMT. Die navorser het afgelei dat hierdie WGMT nie net beperk is tot die vervaardigings sektor nie, maar dat dit ook in die nie-vervaardigings sektor doeltreffend aangewend kan word.

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Cunningham, Daniel Morton. "The impact of aggressive case management service in reducing the frequencies of acute episodes of the chronically mentally ill." CSUSB ScholarWorks, 1996. https://scholarworks.lib.csusb.edu/etd-project/1287.

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26

Esser, Jan Hendrik. "Who cares? : moral reflections on business in healthcare." Thesis, Stellenbosch : Stellenbosch University, 2001. http://hdl.handle.net/10019.1/52612.

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Thesis (MPhil)--University of Stellenbosch, 2001.
ENGLISH ABSTRACT: This evaluation serves the purpose of illuminating concepts and ideas behind the moral impact of business values in healthcare and to establish a framework for the analysis of moral dilemmas found in the sphere ofbio-medical ethics. The historic developments of business in healthcare are examined, looking at how and why business became an integral part of the health care system. The concept of "managed healthcare" is introduced and used as the context in which the different institutional role-players are brought together. Managed healthcare is defined by a discussion of the different organisational structures through which it manifests itself. The policies, procedures and regulations that managed healthcare organisations implement and control to fulfil their general function are also examined. Some normative aspects pertaining to the concept of managed health care are explored, including the institutional values of business and that of medicine. A brief discussion of the economic system in which the business agents or role players function are included in the evaluation of the institutional values of business. Further arguments are made to show how the healthcare system with all its role players displays the characteristics of a complex system. Discussions on the fundamental values of medicine concentrate on the basic ideas behind virtues and principles of medical ethics. It is argued that the development of these virtues and principles are important foundations on which the medical profession stands. The moral impact of combining these institutional values within the context of managed healthcare relationships is examined and some important moral dilemmas or conflicts are identified. It is further argued that the fundamental relationships between all the role players in the health care system have changed as all the agents function within a complex system, giving rise to new organisational structures and relationships, with new conceptual roles, ideals, values and practices.
AFRIKAANSE OPSOMMING: Hierdie evaluasie het dit ten doelom sekere konsepte en idees agter die morele impak van besigheidswaardes in gesondheidsorg te illumineer en om 'n raamwerk daar te stel vir die verdere analise van morele dilemmas in die sfeer van bio-mediese etiek. Die historiese ontwikkeling van besigheid in gesondheidsorg word verken deur die redes aan te voer waarom besigheid deel van die gesondheidsorgsisteem geword het. Die konsep "bestuurde gesondheidsorg" word gebruik as die konteks waarin die verskillende institusionele rolspelers bymekaar gebring word. Bestuurde gesondheidsorg word gedefinieer deur die verskillende organisatoriese strukture waardeur dit manifesteer. Die prosedures, regulasies en bereid wat bestuurde gesondheidsorgorganisasies implementeer om hul funksies te vervul word ook verken. Normatiewe aspekte van bestuurde gesondheidsorg word verken, waarby ingesluit word die institusionele waardes van besigheid sowel as dié van medisyne. 'n Kort beskrywing van die ekonomiese sisteem waarin die besigheidsagente, of rolspelers funksioneer word ingesluit by die evaluasie van die institusionele waardes van besigheid. Verdere argumente word gevoer om te wys daarop hoe die gesondheidsorgsisteem met al sy rolspelers die karakter toon van 'n komplekse sisteem. Die basiese idees agter deugsaamheid en morele beginsels van bio-mediese etiek word bespreek om die fundamentele waardes van medisyne te beskryf. Daar word geargumenteer dat die ontwikkeling van hierdie waardes 'n belangrike fondament is waarop die mediese professie staan. Die morele impak van die kombinasie tussen die institusionele waardes van besigheid en medisyne binne die konteks van bestuurde gesondheidsorg word geevalueer en belanrike morele dilemmas en konflikte word geidentifiseer. Verder word geargumenteer dat die fundamenrele verhouding tussen al die rol spelers in die gesondheidsisteem verander het danksy die funksionering van die agente binne hierdie komplekse sisteem. Dit lei op sy beurt na veranderinge in organisatoriese strukture en verhoudinge met nuwe konsepsuele rolle, idiale, waardes en praktyke.

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Peters, Candice Marie. "A comparison of the levels of patient staffing ratios and staffing mix to the number of patient falls in an acute care setting." CSUSB ScholarWorks, 1997. https://scholarworks.lib.csusb.edu/etd-project/1314.

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Behkami, Nima A. "Examining Health Information Technology Implementations: Case of the Patient-Centered Medical Home." PDXScholar, 2012. https://pdxscholar.library.pdx.edu/open_access_etds/237.

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It has been shown that the use of Health Information Technology (HIT) is associated with reduced cost and increased quality of care. This dissertation examined the use of registries in Patient Centered Medical Home (PCMH) practices. A survey questionnaire was sent to a nationwide group of clinics certified for being a PCMH. They were asked to provide information about their payer mix, implementation barriers, registry implementation, registry use, and clinic satisfaction. The survey instrument was validated by an expert panel which included practitioners and researchers. Statistical methods including Structural Equation Modeling were used for analysis and to test the research hypotheses. The majority of medical home practices that responded used some type of computerized registry, either with basic patient information or integrated with detailed clinical information. And on average, they somewhat used registries for population management, individual health management, proactive care and planned care visits. All practices encountered some combination of barriers when implementing a medical home program. Most practices reported clinic satisfaction at least improved after becoming a medical home. The results of the analysis show that indeed payer mix, in particular Medicare and private insurance, has a significant relationship with level of registry implementation. There were no significant relationships between barriers and registry implementation or use. More sophisticated registry implementation led to greater registry use. And registry use is associated with increased clinic satisfaction. This research fills an important gap in understanding Health IT use, registries in particular, among Patient-Centered Medical Homes. The findings suggest that: 1) Implementation barriers may not be influencing use of computerized registries in medical home practices; 2) Using more sophisticated computerized registries facilitates registry use, which can help improve clinic satisfaction; 3) Payer mix may influence use of more sophisticated Health IT in medical home practices.

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Tucker, Melody A. "A Time Study of Audiological Practice Patterns and the Impact of Reimbursement Changes from Third Part Payers." Scholar Commons, 2001. https://scholarcommons.usf.edu/etd/1543.

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The primary objective of the project was to survey audiologists in clinical practice setting to determine the amount of time taken to perform various audiologic tests using Current Procedural Terminology, (CPT) codes to define these tests and if these CPT codes were felt to be adequate. Audiologists were also asked to respond regarding possible impact and reimbursement changes in their clinical practices related to managed care. Responses of audiologists were analyzed to determine: a) adequacy of CPT codes; b)average time to perform various audiologic tests; c) impact managed care onclinical practice; and d) changes in reimbursement as a result of managed care. The survey was designed to determine the type of work setting, typical job duty, average monthly caseload and hours per day spent on patient care for each respondent. The survey with a cover letter explaining the purpose was mailed to 93 audiologists in clinical setting in the state of Florida. Five were returned undeliverable, and 39 of the remaining 88 were returned either completed or partially completed. The survey results revealed over 71% of the audiologists felt the current CPT codes were adequate. Time spent performing traditional audiologic tests, such as comprehensive audiometric evaluations and impedance testing, was fairly consistent. Greater time variability occurred in tests used to determine vestibular function. Over three-quarters of the respondents believed managed care has had a negative impact on their clinical practices, while 11% believe they have been positively impacted. Approximately 82% of the audiologists have had reductions in reimbursement as a result of managed care, while 10% have seen no change and 5% have enjoyed slightly greater reimbursement.

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Castro, Lyndon Troy. "The variations in health maintenance organization (HMO) and Medicaid mortality and preventable readmissions." CSUSB ScholarWorks, 1997. https://scholarworks.lib.csusb.edu/etd-project/1307.

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The rising costs of health care and burgeoning government deficits have prompted new ways to control costs, while continuing to provide necessary health care. One method increasingly chosen by states to achieve these objectives is managed health care. There are many forms of managed care organization today. There are HMOs that provide the financing and delivery systems under the control of a single for-profit or non-profit organization; preferred provider organizations consisting of providers that have a pre-negotiated and usually discounted rate for services; administration service organizations that provide claims adjudication; and managed indemnity services organizations that use case management to control costs, while providing beneficiary freedom of choice.

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Wilson, Anne 1953 Apr 24. "Self-employed nurse entrepreneurs expanding the realm of nursing practice: a journey of discovery." 2003. http://thesis.library.adelaide.edu.au/public/adt-SUA20030711.100333.

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Includes bibliographical references. Electronic publication: Full text available in PDF format; abstract in HTML format. Private practice as a career option for nurses has been slowly increasing since the 1980's. However, the reasons for this development have not been fully investigated so that it can be understood and placed within the changing contexts of health care and health services. The expansion and extension of nurses' roles is a contemporary topic in health care reform and therefore one that deserves investigation. The aims of this study were to develop a theory on private practice nursing and to describe the characteristics and work of the self-employed nurse in Australia. Electronic reproduction.[Australia] :Australian Digital Theses Program,2001.xvii, 350 leaves : ill. (some col.) ; 30 cm.

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Wilson, Anne. "Self-employed nurse entrepreneurs expanding the world of nursing practice: a journey of discovery." 2003. http://hdl.handle.net/2440/37903.

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Private practice as a career option for nurses has been slowly increasing since the 1980's. However, the reasons for this development have not been fully investigated so that it can be understood and placed within the changing contexts of health care and health services. The expansion and extension of nurses' roles is a contemporary topic in health care reform and therefore one that deserves investigation. The aims of this study were to develop a theory on private practice nursing and to describe the characteristics and work of the self-employed nurse in Australia. Nurses working in a variety of settings have been able to provide information on being self-employed. In doing so, this study was able to describe the persona of the nurse entrepreneur, explore the reasons why nurses and midwives in Australia establish private fee-for-service practices, identify the factors which have influenced this action and describe the scope of practice of nurses and midwives in private practice. This combined Delphi technique and Grounded Theory study is the first in-depth study of Australian nurses and midwives in private practice. The study enables nurses to provide direct information on being self-employed and enhances the profession's ability to articulate about this area of nursing. The significance of the research is in increasing the understanding of this area of practice development and affords greater insight into its efforts to improve and maintain quality nursing services within the Australian health care system. One hundred and six nurses and midwives were invited to participate in the study, in which participants completed two rounds of semi-structured postal questionnaires. Delphi technique was applied to rate responses on Likert scales to ascertain respondents' consensus on certain topics. Participants were also provided the opportunity to make additional comments. Results indicated that nurses in private practice are well experienced with an average of 21 years nursing experience and hold several qualifications. Job satisfaction, being able to be more involved in achieving quality health outcomes and maximising skills and abilities are significant influences for private practice. These results suggest that private practice nursing can contribute effectively to broadening the range of primary health services available to the population and to addressing the issues of retention and recruitment of nurses. Self-employed nurse entrepreneurs push the boundaries of the profession and expand the realm of nursing practice. Entrepreneurship is a path for the future of nursing as it offers expanded career opportunities for nurses and opportunities for increased ambulatory health services. In addition, the broad, expert knowledge nurses hold on many aspects of health can be disseminated throughout the health sector to the advantage of corporate health partners. There is further development required in this innovative and expanding area of the nursing profession.
Thesis (Ph.D.)--Department of Clinical Nursing, 2003.

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Mills, David (Peter David Duncombe). "The role of goal setting in the diabetes case management of aboriginal and non-aboriginal populations in rural South Australia / David Mills." 2005. http://hdl.handle.net/2440/38374.

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Includes publications published as a result of ideas developed in this thesis, inserted at end.
"April 2005"
Includes bibliographical references (leaves 210-242)
242 leaves :
Title page, contents and abstract only. The complete thesis in print form is available from the University Library.
Examines goal setting in people with diabetes as part of chronic disease management in a rural setting. The studies were performed in Eyre Peninsula with a significant (10-20%) Aboriginal population.
Thesis (M.D.)--University of Adelaide, Dept. of General Practice, 2005

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Khosi, Lefume Samuel. "Perceptions of medical practitioners towards managed healthcare." Thesis, 2014. http://hdl.handle.net/10210/10497.

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M.Com. (Business Management)
The purpose of the present study was to investigate the perceptions of medical practitioners towards managed health care and its implications for patient care. The study population was the medical practitioners in the northern suburbs of Johannesburg. A questionnaire was distributed to 224 medical practitioners in the northern suburbs of Johannesburg. The total number of the respondents was 81 with 53% being general practitioners and 47% being specialists. The findings of the study indicated that the majority of respondents perceived managed healthcare to have a negative impact on doctor-patient relationship, the ability to carry out their ethical obligations towards the patients, and that the limitations implemented by managed health care have a negative impact on the quality of care. The respondents also perceived managed healthcare to be consistent in reducing unnecessary procedures and reducing the expenditure. Recommendations made to remedy the situation include introducing a topic of managed health care as part of undergraduate studies to empower practitioners before they start a private practice. It would be advisable to include medical practitioners to help reform the strategies that will enable medical practitioners to carry out their ethical obligations towards the patients and to deliver quality care to the patients. The study concluded that medical practitioners hold negative perceptions towards managed health care and perceive managed health care to impact the quality of care negatively.

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Stewart-James, Joy Ellen. "Managed occupational health vs. traditional care a cost and satisfaction analysis of workers' compensation in healthcare workers /." 2002. http://wwwlib.umi.com/cr/utexas/fullcit?p3075618.

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Sumii, Kensuke. "The body of a patient and rational treatment in the managed care era." Thesis, 1997. http://hdl.handle.net/1957/33798.

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This study aims to identify conceptions of the body, as well as "rational" treatment among primary care practitioners (PCPs) and emergency medicine practitioners (EMPs) dealing with managed care plans. I conducted ethnographic study throughout 1996, and interviewed six PCPs and four EMPs. In the course of my interviews, I discovered that EMPs' and PCPs' perceived meaning and power in regards to treatment of their patients has been increasingly resituated by the power of scientific discourse as utilized by technocrats (such as consumer, provider, and insurance organizations who formulate managed care plans). Technocrats have developed scientific measurements to monitor physicians' performances, quantifiably or scientifically. Technocrats conceptualize ideal treatment as a cost effective care. They guide PCPs to supervise ideal treatment of the managed care delivery networks, providing care without referring patients to specialists and administrating to hospitals. Consequently, PCPs' power to pursue the newly conceptualized ideal treatment influences other arenas of specialty, such as EMPs. On the other hand, EMPs develop preferred treatment which is formulated through their medical school education and clinical experiences. The preferred treatment is associated with time because EMPs have to treat acute conditions of their patients within a limited amount of time. However, EMPs sometimes cannot complete their preferred treatment because they have to send their patient back to the patients' contracted PCPs in order to save health care expenditure. Technocrats implemented the engineering concept of quality control, and the concept is incorporated into the principle of managed care plans, and preventive medicine. As a result, the managed care plan networks become like production lines of large manufacturing factories, and PCPs work as laborers to maintain the bodies of enrollees in healthy conditions.
Graduation date: 1998

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Tansey, Kathryn J. "Care manager's utilization of project time in a physician sponsor plan Medicaid demonstration project report of a research experience submitted in partial fulfillment ... for the degree of Master of Science in Nursing ... /." 1995. http://catalog.hathitrust.org/api/volumes/oclc/68798772.html.

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Groenewald, C. A. "A critical evaluation of the introduction of managed health care into the South African private health care industry." Thesis, 2012. http://hdl.handle.net/10210/7322.

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M.Comm.
Health care is recognised as a basic human right. The current position of private health care in South Africa is of great concern. Not only is health care almost unaffordable but the future quality of health care also causes great concern. With this in mind it is obvious that alternatives to conventional medical aids and health insurance are necessary to guarantee the continued availability of quality medical care to the South African public. Most people would agree that our private sector health care system is characterised by a depressing history of inadequate planning, control and management. It is for this reason that amendments to the Medical Schemes Act were considered necessary. Certain of these amendments will extend the role played by medical schemes in the management of health care resources. This will result in the traditional boundaries and relationships between the public, health professionals and health care facilities, and the financiers in our private health care system being altered. A new philosophy will evolve based on open and participative practices, as well as increased coordination, integration and cooperation (Veliotes et al, 1993: 12). Internationally, the health care objectives of most countries are to provide access to highquality care for all the people, and to provide this care efficiently and effectively. In the last decade the task of achieving these potentially conflicting objectives has become more difficult. At present, private health care is funded by medical schemes, health insurance companies, employers and individuals themselves. Neither medical aids nor health insurance companies are able to contain the rise in health care cost, which has led to the emergence of a new method of finding, namely Managed Health Care (MHC). Health care cost has accelerated at a rate far above the consumer price index(CPI). Rising health care costs in the private sector have been blamed on structural inefficiencies in the medical aid system. While patients have little incentive to minimise care expenditure, providers have an incentive to overuse the system.

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Leonard, Patricia A. "The work of care managers in a Medicaid demonstration project for the Modified Physician Sponsor Plan in Washtenaw Country, Michigan a descriptive analysis : submitted in partial fulfillment ... for the degree of Master of Science in Nursing (Parent-Child Nursing) ... /." 1995. http://catalog.hathitrust.org/api/volumes/oclc/68798773.html.

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Molitor, Stacey. "Evaluation of care manager encounters in the Modified Physician Sponsor Plan of Washtenaw County report of a research experience submitted in partial fulfillment ... for the degree of Master of Science in Nursing ... /." 1995. http://catalog.hathitrust.org/api/volumes/oclc/68798770.html.

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Keys, Robert T. III. "Preferred customers? : barriers for Hispanics in Oregon's managed care Medicaid program." Thesis, 2002. http://hdl.handle.net/1957/28459.

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From February to September of 2001, a significant body of qualitive data was collected to investigate barriers for Hispanic participation in Oregon's managed care Medicaid program. As a means to investigate this topic, comments were solicited from physicians, hospital administrators, social service agencies, and low-income Hispanics through semi-structured focus groups and individual interviews. This methodology presents the reader with a rich enthnohistoric and cultural context to the local issues surrounding Hispanic under-participation in Oregon's managed care Medicaid program. Finally, through an analytical framework of critical medical anthropology, connections are drawn from local barriers to state and corporate policies.
Graduation date: 2002

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Crowder, Terry J. "An evaluation of community pharmacists applying the patient centered care approach to ambulatory Oregon Health Plan asthmatics in a Managed Care setting." Thesis, 2000. http://hdl.handle.net/1957/33414.

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Purpose: The Purpose of this research was to design, implement and evaluate a patient centered asthma intervention pilot program directed by physicians and administered by community pharmacists to a group of Managed Care contracted Oregon Health Plan asthmatics. The evaluation was to determine if the proposed intervention could improve the enrolled asthma patient's related education and quality of life while simultaneously creating economic benefit for the sponsoring health plan. Methods: The study was designed to be a prospective, six month pre and posttest quasi-experimental evaluation combined with a Solomon-like two-control group comparison. All patients in the sponsoring health plan twelve years of age and older who had six months of continuous enrollment were eligible. Enrollment of the target patients was voluntary and the time period of the evaluation (November, 1997 to May, 1998) was purposely conducted to capture the notoriously difficult asthma trigger cold and allergy seasons. Information regarding the cost and frequency of pre and post emergency room visits, hospitalizations, physician's office and medications use and Health Related Quality of Life (HRQL) was collected for the intervention group and control group. Satisfaction information for the major actors was collected and analyzed at posttest. Within group comparisons were conducted using the paired T-test and the unpaired T-test was used for between group comparison. Results: Patients in the intervention group who had their physician and pharmacist fully participate in respectively directing and administering the study protocol showed associated improvements in their quality of life measures. Economic benefit to the health plan is suggested by a cost benefit ratio of 1:5.71 resulting from favorable decreases in health care related resources and improved asthma related medication utilization. Analysis of the satisfaction measures suggests that all the major participants were very satisfied with the intervention. Conclusion: Even though the sample size in this pilot study was relatively small, the resulting information should not be immediately discounted. The evidence suggests that in those cases where the study protocol was followed, favorable economic, HRQL and satisfaction is comparable to larger, previously conducted studies.
Graduation date: 2000

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Bornman, Magda. "Digital media as communication tools for health promotion in managed health care." Diss., 2001. http://hdl.handle.net/2263/26249.

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Atherton, Martin. "The effects of health plan model on access to prenatal care and birth outcomes Medicaid managed care and Medicaid fee-for-service health plans in California : 1995-1997." 2001. http://books.google.com/books?id=ojBYAAAAMAAJ.

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Kgasi, Kate Mamokgati. "The role of a case manager in a managed care organisation." Diss., 2010. http://hdl.handle.net/10500/4101.

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The purpose of this study was to determine case managers’ understanding of their role in a managed care organisation and to develop recommendations for the improvement of case management practice. Quantitative descriptive research was conducted to explore perceptions of case managers regarding their role. A self-administered questionnaire was used as a formal data collection instrument and 25 respondents participated in the study. The findings revealed that the majority of case managers know what is expected of them in their job but that they do experience some barriers. There appears to be uncertainty with quite a number of respondents regarding certain aspects of their role. Recommendations were made for improved case management practice.

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Seymore, Martha Magarieta. "Cost-effective delivery of managed nurse-based primary health care in a selected medical scheme." 2001. http://hdl.handle.net/10500/17720.

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The study was aimed at furthering the health objectives of the government's Reconstruction and Development Programme (ANC 1994b) in the area of primary health care. . The purpose of the study was to examine the possible reduction of medical scheme claims for cardiovascular disease by means of primary health care, so that medical scheme benefits do not become exhausted so rapidly. The overall outcome of the study showed that if cardiovascular disease could be diagnosed and treated early, the financial benefits could be substantial. This was illustrated by the comparison of primary, secondary and tertiary treatment of cardiovascular disease using case studies over a period of one year. Recommendations centered around nurse-based primary health care for cardiovascular disease and the cost-effective management of the medical scheme. It was concluded that as a result of nurse-based primary health care, costs could be contained so that medical scheme benefits would not become exhausted so rapidly.
Health Studies
M.A. (Nursing Science)

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Straulino, Patrizia. "Exploring the attraction of nurses to a managed care organization." Diss., 2012. http://hdl.handle.net/10500/13107.

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The main aim of this research study was to explore attraction factors pertaining to the literature and to the occupational context of nursing personnel who have exhibited employment interest in a managed care organisation. A qualitative research approach was adopted in which semi-structured interviews were held to collect rich exploratory data from the purposeful sample of nine applicants with nursing qualifications. Twenty-five themes were identified through interpretive data analysis as being important factors in the pre-interview attraction process. The highest ranking of these were identified to be opportunities for professional and personal growth and the relationship with the managed care client, followed by salary and working hours. This study contributes knowledge to Personnel and Career Psychology in the field of Industrial and Organisational Psychology and is pertinent to organisations recruiting nurses, advising them in the formulation of contextually appropriate attraction strategies that attend to the most notable attraction factors
Industrial & Organisational Psychology
M.Com. (Industrial and Organizational Psychology)

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Kramer, Barbara. "Mental health issues for families served by a care manager under a managed care Medicaid project : b report of a research experience : submitted in partial fulfillment ... for the degree of Master of Science in Nursing ... / c Barbara Kramer." 1995. http://catalog.hathitrust.org/api/volumes/oclc/68798771.html.

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Ranieri, Michael James. "HEDIS and its impact on nurse practitioners : a report submitted in partial fulfillment ... for the degree of Master of Science, Community Health Nursing." 1999. http://catalog.hathitrust.org/api/volumes/oclc/68901161.html.

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Howard, Steven W. "Medicare managed care : market penetration and the resulting health outcomes." Thesis, 2011. http://hdl.handle.net/1957/26133.

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Managed care plans purport to improve the health of their members with chronic diseases. How has the growing adoption of Medicare Advantage (MA), the managed care program for Medicare beneficiaries, affected the progression of chronic disease? The literature is rich with articles focusing on managed care organizations' impacts on quality of care, access, patient satisfaction, and costs. However, few studies have analyzed these impacts with respect to market penetration of Medicare managed care. The objective of this research has been to analyze the relationships between the market penetration of MA plans and the progression of chronic diseases among Medicare beneficiaries. The Chronic Disease Severity Index scale (CDSI) was constructed to represent beneficiaries' overall chronic disease states for survey or claims-based data, when more direct clinical measures of disease progression are not available. Using the CDSI on the MEPS survey dataset from AHRQ, we sought to assess the impacts of MA market penetration and other covariates on the overall chronic disease state of Medicare beneficiaries from 2004 through 2008. Though the model explains much of the variation in CDSI change, the author expected the multilevel model would show that MA penetration explains a significant level of variation in CDSI change. However, this hypothesis was not substantiated, and the findings suggest that unmeasured factors may be contributing to additional unexplained heterogeneity. Policymakers should explore opportunities to refine the current MA program. The MA program costs the federal government more than the Traditional Fee-for-Service Medicare program, and there is no definitive evidence that outcomes differ. Within both programs, there is opportunity to experiment with different models of payment, healthcare service delivery and care coordination. The Patient Protection and Affordable Care Act (ACA) contains provisions for innovative demonstration projects in delivery and payment. The effectiveness of these ACA initiatives must be monitored, both for impacts on health outcomes and for economic effects. This research can inform future approaches to outcomes assessment using the CDSI, and multilevel modeling methodologies similar to those employed here. Firms offering MA health plans would be prudent to proactively demonstrate their value to beneficiaries and taxpayers. They should explore means of better monitoring and reporting the longitudinal outcomes of their enrolled beneficiaries. Demonstrating that they can bring value in terms of improved health outcomes will help insure their long-term survival, both in the marketplace and in the political arena.
Graduation date: 2012

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