Relevant bibliographies by topics / Managed health care model

Academic literature on the topic 'Managed health care model'

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Published: 4 June 2021
Last updated: 13 February 2022

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Journal articles on the topic "Managed health care model"

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Cheng, Shou-Hsia, Chih-Ming Chang, Chi-Chen Chen, Chih-Yuan Shih, and Shu-Ling Tsai. "Half-Managed Care." International Journal of Health Services 47, no. 3 (November 19, 2015): 519–31. http://dx.doi.org/10.1177/0020731415615310.

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In 2011, a novel capitation program was launched in Taiwan under its universal health insurance plan. This study aimed to assess the short-term impact of the program. Two hospitals in the greater Taipei area, one participating in the “loyal patient” model (13,319 enrollees) and one in the “regional resident” model (13,768 enrollees), were analyzed. Two comparison groups were selected by propensity score matching. Generalized estimating equation models with differences-in-differences analysis were used to examine the net effects of the capitation program on health care utilization, expenses, and outcomes. Enrollees in the loyal patient model had fewer physician visits in the host hospital, but more physician visits outside that hospital during the program year than they had the year before. Compared with non-enrollees, the loyal patient model enrollees incurred fewer physician visits (β = −0.042, p < .001), fewer emergency department visits, (β = −0.140, p < .001), and similar total expenses and outcome. For the regional resident model, no differences were found in the number of physician visits, expenses, or outcomes between enrollees and non-enrollees. The novel capitation models in Taiwan had minimal impact on health care utilization after 1 year of implementation and the health care outcome was not compromised.
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Neufeld, Jonathan D., Robert E. Hales, Edward J. Callahan, and Thomas F. Anders. "Managed Care: The Behavioral Health Center: A Model for Academic Managed Care." Psychiatric Services 51, no. 7 (July 2000): 861–64. http://dx.doi.org/10.1176/appi.ps.51.7.861.

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Trombetta, William. "Managed care Medicaid." International Journal of Pharmaceutical and Healthcare Marketing 11, no. 2 (June 5, 2017): 198–210. http://dx.doi.org/10.1108/ijphm-09-2016-0049.

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Purpose Providing health care to the poor is evolving in the new US marketplace. The Affordable Care Act has set goals enhancing access to health care, lowering costs and improving patient outcomes. A key segment in this evolution is the most vulnerable health-care population of all: Medicaid. This paper aims to provide a general review of how providing health care to Medicaid patients is changing including how socio-economic aspects of this vulnerable population affects the quality of the health care provided. Design/methodology/approach The paper is entirely secondary research; no primary research has been conducted. Findings Managed care Medicaid provides a risk-based model to treating a vulnerable health-care market segment. The jury is still out on whether managed care Medicaid (MCM) is improving health-care quality and saving cost, but the provision of health care to the Medicaid segment is definitely shifting from a fee-for-service model to value based payment. Very recent developments of new health-care delivery approaches present a positive outlook for improving quality and containing costs going forward. Research limitations/implications At this stage, whether or not MCM saves money or provides better health-care quality to this vulnerable population is a work in progress. Health-care marketing can impact socio-economic aspects of health care for the poor. There is a need to follow up on the positive results being documented in demonstration health-care delivery models. Practical implications At this point, there has been no long-term study of whether managed care Medicaid offers better quality of health care and cost savings. The research to date suggest that the quality of health-care delivery to the poor is improving at a lower cost to payers. Social implications Medicaid patients are an underserved market segment. Managed care Medicaid offers a new model that has the potential to provide quality care at acceptable cost. Critical to this vulnerable market segment is the need to integrate socio-economic aspects of the population with the delivery of health care. Originality/value There has been very little discussion of Medicaid overall in the marketing literature, much less any discussion of managed care Medicaid.
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Weil, Thomas P. "Managed Care Merged with the German Model." American Journal of Medical Quality 12, no. 1 (March 1997): 19–24. http://dx.doi.org/10.1177/0885713x9701200104.

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Weil, Thomas P. "Merging managed care with the German model." International Journal of Health Planning and Management 12, no. 2 (April 1997): 115–30. http://dx.doi.org/10.1002/(sici)1099-1751(199704)12:2<115::aid-hpm462>3.0.co;2-w.

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Henley, A. J., and Maurice C. Clifford. "Managed Health Care for Medicaid Enrollees: The Philadelphia Model." Journal of Health Care for the Poor and Underserved 4, no. 3 (1993): 210–18. http://dx.doi.org/10.1353/hpu.2010.0212.

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Carter, Jean A. "Adjustment Disorders: A Managed Care Model of Mental Health." Contemporary Psychology: A Journal of Reviews 42, no. 12 (December 1997): 1101–2. http://dx.doi.org/10.1037/000653.

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Herron, William G., and Lydia K. Adlerstein. "The Dynamics of Managed Mental Health Care." Psychological Reports 75, no. 2 (October 1994): 723–41. http://dx.doi.org/10.2466/pr0.1994.75.2.723.

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Presented here is an exploration of the motivations involved in the development and application of managed mental health care to the private practice of outpatient psychotherapy. The interaction of management policy and psychotherapy is conceptualized in a dynamic model designed to provide insights into effective care policies. The model is described first, then the development of managed care, which appears defensive and is becoming symptomatic to the point of needing significant change. It is suggested that management policies providing choices of therapists and therapies will be the most effective in addressing ethical, fiscal, and psychological concerns of funders, consumers, and providers.
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Horn, Susan D., Phoebe D. Sharkey, and Richard Levy. "A Managed Care Pharmacoeconomic Research Model Based on the Managed Care Outcomes Project." Journal of Pharmacy Practice 8, no. 4 (August 1995): 172–77. http://dx.doi.org/10.1177/089719009500800405.

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Many American health care facilities have come to understand that quality controls cost. Clinical practice improvement (CPI) is a methodology that creates a clinical laboratory, built into the everyday practice setting, to find and test the best practices. A CPI study is an analysis of the content and timing of the individual steps of a medical care process to produce better clinical outcomes for the least necessary cost over the continuum of a patient's care. Statistical analyses are used to determine whether and how much a particular step actually improves medical outcomes. Systematic determination of individual medical process steps that improve medical outcomes is the best way to develop demonstrably better care and practice. Combining CPI methodology and a clinical quality monitor creates a dynamic environment in which all patient encounters potentially contribute to improving the process of care. We describe a recent multisite study: the Managed Care Outcomes Project (MCOP). The MCOP study design permits us to compare the effects of various pharmaceutical treatments on resource utilization in actual practice in managed care organizations. The MCOP database is an important resource for developing information required to design systems-based disease management programs. Copyright © 1995 by W.B. Saunders Company
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Browngoehl, K., K. Kennedy, K. Krotki, and H. Mainzer. "Increasing Immunization: A Medicaid Managed Care Model." PEDIATRICS 99, no. 1 (January 1, 1997): e4-e4. http://dx.doi.org/10.1542/peds.99.1.e4.

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Dissertations / Theses on the topic "Managed health care model"

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McCabe, Helen, and res cand@acu edu au. "The Ethical Implications of Incorporating Managed Care into the Australian Health Care Context." Australian Catholic University. School of Philosophy, 2004. http://dlibrary.acu.edu.au/digitaltheses/public/adt-acuvp48.29082005.

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AIMS Managed care is a market model of health care distribution, aspects of which are being incorporated into the Australian health care environment. Justifications for adopting managed care lie in purported claims to higher levels of efficiency and greater ‘consumer’ choice. The purpose of this research, then, is to determine the ethical implications of adapting this particular administrative model to Australia’s health care system. In general, it is intended to provide ethical guidance for health care administrators and policy-makers, health care practitioners, patients and the wider community. SCOPE Managed care emerges as a product of the contemporary, neo-liberal market with which it is inextricably linked. In order to understand the nature of this concept, then, this research necessarily includes a limited account of the nature of the market in which managed care is situated and disseminated. While a more detailed examination of the neo-liberal market is worthy of a thesis in itself, this project attends, less ambitiously, to two general concerns. Firstly, against a background of various histories of health care distribution, it assesses the market’s propensity for upholding the moral requirements of health care distributive decision-making. This aspect of the analysis is informed by a framework for health care morality the construction of which accompanies an inquiry into the moral nature of health care, including a deliberation about rights-claims to health care and the proper means of its distribution. Secondly, by way of offering a precautionary tale, it examines the organisational structures and regulations by which its expansionary ambitions are promoted and realised. CONCLUSIONS As a market solution to the problem of administering health care resources, the pursuit of cost-control, if not actual profit, becomes the primary objective of health care activity under managed care. Hence, the moral purposes of health care provision, as pursued within the therapeutic relationship and expressed through the social provision of health care, are displaced by the economic purposes of the ‘free’ market. Accordingly, the integrity of both health care practitioners and communities is corrupted. At the same time, it is demonstrated that the claims of managed care proponents to higher levels of efficiency are largely unfounded; indeed, under managed care, health care costs have continued to rise. At the same time, levels of access to health care have deteriorated. These adverse outcomes of managed care are borne, most particularly, by poorer members of communities. Further, contrary to the claims of its proponents, choice as to the availability and kinds of health care services is diminished. Moreover, the competitive market in which managed care is situated has given rise to a plethora of bankruptcies, mergers and alliances in the United States where the market is now characterised by oligopoly and monopoly providers. In this way, a viable market in health care is largely disproved. Nonetheless, when protected within a non-market context and subject to the requirements of justice, a limited number of managed care techniques can assist Australia’s efforts to conserve the resources of health care. However, any more robust adoption of this concept would be ethically indefensible.
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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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Nearon, Darrell Maxwell Jr. "A study of the relationship between health care access and access barriers to behavioral health care for African Americans utilizing the managed care model." DigitalCommons@Robert W. Woodruff Library, Atlanta University Center, 2001. http://digitalcommons.auctr.edu/dissertations/AAI3034591.

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Managed care has revolutionized the healthcare industry. Prior to managed care, traditional insurance companies managed the healthcare industry. These insurance firms would monitor and authorize treatment to persons enrolled with the insurance company. Health Maintenance Organizations (HMOs) began to develop methods to provide similar service as the large insurance companies at a fraction of the cost. HMOs accomplished this by selling their products directly to employer groups. This significantly reduced administrative costs that had been traditionally passed on to the consumer. Unable to financially keep pace with the HMOs, the insurance companies abandoned the health insurance arena. As managed care has grown so have the problems associated with his system. Issues involving antitrust, confidentiality, privacy, and best practices are but a few of the critical issues facing managed care. All three branches of the United States government have been involved in resolving issues pertaining to managed care. Reforms have been demanded from the system and the current political climate may force the system to reconsider the manner in which it is conducting business. Minority consumers and specifically African Americans traditionally have been discriminated against from engaging in such life activities as housing, voting, commerce, and banking, without judicial intervention. The healthcare industry is no exception. The United States Surgeon General, in his seminal report on mental health, identifies that African Americans and other minorities have been excluded from obtaining appropriate and timely healthcare. The Surgeon General's report coupled with the President's report on Healthy People 2000, identify that initiatives are needed to rectify the inequities in healthcare in healthcare service delivery. A total of fifty-two African American consumers of mental health service with a primary diagnosis of adjustment disorder were surveyed to assess their perceptions as to whether or not they have access to their behavioral health services. The Consumer Access Questionnaire was designed to gather both demographic and consumer perceptions on the accessibility and feasibility of managed care for this selected population of African Americans. In all categories surveyed on the questionnaire, the results revealed that the respondents were able to access their outpatient behavioral health provider when utilizing the managed care system. The respondents provided an overall satisfaction rate with their respective managed care plans.
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Nearon, Darrell M. "A study of the relationship between health care access and access barriers to behavioral health care for African Americans utilizing the managed care model." DigitalCommons@Robert W. Woodruff Library, Atlanta University Center, 2001. http://digitalcommons.auctr.edu/dissertations/3784.

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Managed care has revolutionized the healthcare industry. Prior to managed care, traditional insurance companies managed the healthcare industry. These insurance firms would monitor and authorize treatment to persons enrolled with the insurance company. Health Maintenance Organizations (HMOs) began to develop methods to provide similar service as the large insurance companies at a fraction of the cost. HMOs accomplished this by selling their products directly to employer groups. This significantly reduced administrative costs that had been traditionally passed on to the consumer. Unable to financially keep pace with the HMOs, the insurance companies abandoned the health insurance arena. As managed care has grown so have the problems associated with his system. Issues involving antitrust, confidentiality, privacy, and best practices are but a few of the critical issues facing managed care. All three branches of the United States government have been involved in resolving issues pertaining to managed care. Reforms have been demanded from the system and the current political climate may force the system to reconsider the manner in which it is conducting business. Minority consumers and specifically African Americans traditionally have been discriminated against from engaging in such life activities as housing, voting, commerce, and banking, without judicial intervention. The healthcare industry is no exception. The United States Surgeon General, in his seminal report on mental health, identifies that African Americans and other minorities have been excluded from obtaining appropriate and timely healthcare. The Surgeon General’s report coupled with the President’s report on Healthy People 2000, identify that initiatives are needed to rectify the inequities in healthcare in healthcare service delivery. A total of fifty-two African American consumers of mental health service with a primary diagnosis of adjustment disorder were surveyed to assess their perceptions as to whether or not they have access to their behavioral health services. The Consumer Access Questionnaire was designed to gather both demographic and consumer perceptions on the accessibility and feasibility of managed care for this selected population of African Americans. In all categories surveyed on the questionnaire, the results revealed that the respondents were able to access their outpatient behavioral health provider when utilizing the managed care system. The respondents provided an overall satisfaction rate with their respective managed care plans. 2
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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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Flood, Colleen M. "Comparing models of health care reform, internal markets and managed competition." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1998. http://www.collectionscanada.ca/obj/s4/f2/dsk2/tape15/PQDD_0003/NQ33923.pdf.

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Dune, Douglas T. "An Expandable Markov Model for the Design of Intelligent Communicative Agents in managed Health Care." NSUWorks, 2000. http://nsuworks.nova.edu/gscis_etd/497.

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In the field of medicine, decisions are often difficult to make in the absence of clear symptoms, decisive test results and adequate patient involvement. Medicine in most cases is still an art, using science for its basic foundation. Everyday practice relies on the case-study method, trial and error, and intuitive judgement. In some medical specialties there is heavy reliance on intangibles. For example, human motivation plays a significant role in complex medical decisions affected by many variables which remain unquantifiable and intangible; indeed most variables that determine outcome are hidden, including human motivation. The complexity of medical information systems demands that new ways be investigated that emphasize timeliness and efficiency. Medical information systems are no longer centralized; they are distributed over networks and the Internet. Interoperability has become a requirement in order for these heterogeneous systems be able to exchange information and work together in a cooperative manner. For this reason the design of decision processes within the general domains of medicine require further analyzation and establishing a methodology for developing a flexible agent architecture for the creation of intelligent agent systems in medicine. Thus, this research provided the underlying theoretical framework for the design of interactive intelligent agents in the medical domain examining the design of open and flexible architectures. In the last decade rapid development of agent technologies has occurred. Research of multi-agent systems sprung from earlier works in artificial intelligence and decision sciences. Complementing the study of agent technologies is the discipline of mathematical modeling. Adapted Markov models were applied to facilitate the methodology of the study emphasizing the process by which real decisions are formalized rather than the solution to already formalized problems. Another important element of this dissertation was the use of clinical pathways; fundamental guidelines that are components of managed health care. Clinical pathways were at the core of the architecture and formed the basis of a suitable expandable and adaptive Markov model. The results of the model are a derivation of intelligent agent architecture for the medical domain. The methodology exploited the generality, flexibility and normative power of Markov models, particularly, fully observable Markov decision processes (FOMDP) and partially observable Markov decision processes (POMDP). Based on both the FOMDP and POMDP, an expandable observable Markov decision process (EOMDP) model was formulated. The formulated model was further revised and reformulated based on the phenomenological observation and measure of clinical pathways. This approach is mathematically sound, computationally efficient, and intuitively appealing.
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Janus, Katharina. "Managing health care in private organizations : transaction costs, cooperation and modes of organization in the value chain /." Frankfurt am Main [u.a.] : Lang, 2003. http://www.gbv.de/dms/zbw/371113903.pdf.

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Du, Preez Karen Kay. "Towards a values-based model to manage joint academic appointments in the health sector in South Africa." Diss., University of Pretoria, 2011. http://hdl.handle.net/2263/28293.

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Joint appointments in the health sector in South Africa are made to serve both service and academic functions in one post. Typically the employing organisations are unequal, as one of them is the paying organisation while the other is the academic employer. This practice has been in existence for decades, and is ruled by expediency rather than being based on values. Joint employees experience role confusion, job confusion, dual loyalty confusion and being managed according to the rules of two organisations. This suboptimal situation leads to lower-than-expected performance in the eyes of both employing organisations. In this study the knowledge and problem areas of joint appointments were explored. The first part of the study consisted of a questionnaire analysis of the knowledge and view of problems as expressed by joint staff as well as by human resources (HR) practitioners. Group discussions, as well as the major part of the study, namely, interviews with senior management staff of both organisations were then conducted. In order to complete the study, an analysis was made of values that might inform on the problem. Joint staff members were found to have limited knowledge of the work requirements of a joint employee, and expressed concern about loyalty and role confusion. When the values were discussed with senior management staff, some values were identified as informing on possible solutions such as joint establishment of vision, joint objectives, respect for all components of the job, as well as generic values, including honesty, transparency, fairness, diversity and others. A framework is suggested commenting on the potential place for a values-based approach. From this a model is proposed by means of which a values-based process can be initiated by a top-level agreement meeting (“meeting of the minds”) of both employers that may lead to a single joint vision and set of objectives. From this agreement a policymaking joint body can establish the rules, while application and implementation are monitored by local joint management committees.
Dissertation (MCom)--University of Pretoria, 2011.
Human Resource Management
unrestricted
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Donato, Francis A. "Reforming health care through managed care." Instructions for remote access. Click here to access this electronic resource. Access available to Kutztown University faculty, staff, and students only, 1995. http://www.kutztown.edu/library/services/remote_access.asp.

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Thesis (M.P.A.)--Kutztown University of Pennsylvania, 1995.
Source: Masters Abstracts International, Volume: 45-06, page: 2939. Abstract precedes thesis as [1] preliminary leaf. Typescript. Includes bibliographical references (leaves 91-92).
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Books on the topic "Managed health care model"

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Baker, Laurence Claude. The effect of managed care on health care providers. Cambridge, MA: National Bureau of Economic Research, 1997.

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Frank, Richard G. Measuring adverse selection in managed health care. Cambridge, MA: National Bureau of Economic Research, 1998.

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R, Pope Clyde, ed. Promise and performance in managed care: The prepaid group practice model. Baltimore, Md: Johns Hopkins University Press, 1994.

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Baker, Laurence Claude. Managed care and health care expenditures: Evidence from Medicare, 1990-1994. Cambridge, MA: National Bureau of Economic Research, 1997.

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Frank, Richard G. Parity for mental health and substance abuse care under managed care. Cambridge, MA: National Bureau of Economic Research, 1998.

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Audits, California Bureau of State. Medi-Cal Managed Care Program: The Departments of Managed Health Care and Health Care Services could improve their oversight of local initiatives participating in the Medi-Cal two-plan model. Sacramento, CA: California State Auditor, Bureau of State Audits, 2011.

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Cutler, David M. Prices and productivity in managed care insurance. Cambridge, MA: National Bureau of Economic Research, 1998.

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W, Veeder Nancy, and Pearce Carole W, eds. Nurse-social worker collaboration in managed care: A model of community case management. New York: Springer Pub. Co., 1998.

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McLane, Shelley. Evolving managed care organizations and Ohio health maintenance organizations: Enrollment, tax status, model type, sources of revenue, sources of expense, NCQA accreditation status, financial ratios : (1993 & 1994). Columbus, Ohio: House Insurance Committee, 1996.

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Belli, Paolo. How adverse selection affects the health insurance market. Washington, D.C: World Bank, Development Research Group, Public Economics, 2001.

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Book chapters on the topic "Managed health care model"

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Sovner, Robert. "A psychopharmacology service model." In Psychotherapy in managed health care: The optimal use of time & resources., 86–97. Washington: American Psychological Association, 1991. http://dx.doi.org/10.1037/10098-007.

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Gunstad, Marsha, and Charles F. Sherman. "A model of adolescent inpatient short-term treatment." In Psychotherapy in managed health care: The optimal use of time & resources., 126–37. Washington: American Psychological Association, 1991. http://dx.doi.org/10.1037/10098-010.

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Gilson, Mark. "Combining treatment and professional training within a private practice model." In Earning a living outside of managed mental health care: 50 ways to expand your practice., 159–62. Washington: American Psychological Association, 2010. http://dx.doi.org/10.1037/12138-035.

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Moksnes, Unni Karin. "Sense of Coherence." In Health Promotion in Health Care – Vital Theories and Research, 35–46. Cham: Springer International Publishing, 2021. http://dx.doi.org/10.1007/978-3-030-63135-2_4.

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AbstractThis chapter introduces the concept of sense of coherence which is a core concept in the salutogenic model defined by Aron Antonovsky. The salutogenic model posits that sense of coherence is a global orientation, where life is understood as more or less comprehensible, meaningful, and manageable. A strong sense of coherence helps the individual to mobilize resources to cope with stressors and manage tension successfully with the help of identification and use of generalized and specific resistance resources. Through this mechanism, the sense of coherence helps determine one’s movement on the health ease/dis-ease continuum. Antonovsky developed an instrument named Orientation to Life Questionnaire to measure the sense of coherence which exists in two original versions: a 29-item and a 13-item version. This chapter presents the measurement of the sense of coherence and the validity and reliability of the 13-item scale. It gives a brief overview of empirical research of the role of sense of coherence in association with mental health and quality of life and also on sense of coherence in different patient groups including nursing home residents, patients with coronary heart disease, diabetes, cancer, and mental health problems. It also briefly discusses the implications of using salutogenesis in health care services and the importance of implementing this perspective in meeting with different patient groups. The salutogenic approach may promote a healthy orientation toward helping the patient to cope with everyday stressors and integrate the effort regarding how to help the patient manage to live with disease and illness and promote quality of life.
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Haugan, Gørill, and Monica Eriksson. "Future Perspectives of Health Care: Closing Remarks." In Health Promotion in Health Care – Vital Theories and Research, 375–80. Cham: Springer International Publishing, 2021. http://dx.doi.org/10.1007/978-3-030-63135-2_26.

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AbstractThe Covid-19 pandemic has demonstrated the vulnerability of our health care systems as well as our societies. During the year of 2020, we have witnessed how whole societies globally have been in a turbulent state of transformation finding strategies to manage the difficulties caused by the pandemic. At first glance, the health promotion perspective might seem far away from handling the serious impacts caused by the Covid-19 pandemic. However, as health promotion is about enabling people to increase control over their health and its determinants, paradoxically health promotion seems to be ever more important in times of crisis and pandemics. Probably, in the future, pandemics will be a part of the global picture along with the non-communicable diseases. These facts strongly demand the health care services to reorient in a health promoting direction.The IUHPE Global Working Group on Salutogenesis suggests that health promotion competencies along with a reorientation of professional leadership towards salutogenesis, empowerment and participation are required. More specifically, the IUHPE Group recommends that the overall salutogenic model of health and the concept of SOC should be further advanced and applied beyond the health sector, followed by the design of salutogenic interventions and change processes in complex systems.
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Walkup, James T., and Fiona S. Graff. "Managed Care." In Encyclopedia of Immigrant Health, 1040–44. New York, NY: Springer New York, 2012. http://dx.doi.org/10.1007/978-1-4419-5659-0_481.

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Zaidi, Shabih H. "Managed Health Care." In Ethics in Medicine, 211–21. Cham: Springer International Publishing, 2013. http://dx.doi.org/10.1007/978-3-319-01044-1_8.

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Ozamiz, J. Agustin. "Models of Health Care Systems in Europe." In Manage or Perish?, 199–206. Boston, MA: Springer US, 1999. http://dx.doi.org/10.1007/978-1-4615-4147-9_24.

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Phelps, Charles E. "Health Insurance Supply and Managed Care." In Health Economics, 295–324. 6th edition. | New York, NY : Routledge, 2018.: Routledge, 2017. http://dx.doi.org/10.4324/9781315460499-11.

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McPhail, James R. "Managed Care: Business and Clinical Issues." In Health Informatics, 61–71. New York, NY: Springer New York, 1999. http://dx.doi.org/10.1007/978-1-4612-0521-0_7.

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Conference papers on the topic "Managed health care model"

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González-de Julián, Silvia, Fernando Polo-Garrido, Isabel Barrachina-Martinez, and David Vivas-Consuelo. "PROFITABILITY ANALYSIS OF PUBLIC-PRIVATE PARTNERSHIP IN HEALTHCARE DELIVERY IN SPAIN." In Business and Management 2018. VGTU Technika, 2018. http://dx.doi.org/10.3846/bm.2018.52.

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In the Valencian Community (Spain) there are 5 health districts managed by public-private partnerships. They are the so-called Alzira model, where the concessionaire builds and maintains the hospital facilities and provides health care services. The purpose of this paper is to address problems raised in the calculation of the limiting clause of profitability and to develop a financial statement analysis in order to assess profitability, solvency and liquidity. Results indicate that all concessionaires show very high debt-to-assets ratio, low liquidity, ROA fluctuates between 2.45% and 12.42%, and the IRR varies between 3.47% and 13.15%. Despite this, four of five concessionaries exceed the limiting clause using an “ad hoc” method as proxy of “cash flows”.
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Khudadad, Hanan, and Lukman Thalib. "Antibiotics Prescription Patterns in Primary Health Care in Qatar – A Population based study from 2017 to 2018." In Qatar University Annual Research Forum & Exhibition. Qatar University Press, 2020. http://dx.doi.org/10.29117/quarfe.2020.0169.

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Background: Antibiotics are antimicrobial drugs used in the treatment and prevention of bacterial infections. They played a pivotal role in achieving major advances in medicine and surgery (1). Yet, due to increased and inappropriate use of antibiotics, antibiotic resistance (AR) has become a growing public health problem. Information on antibiotic prescription patterns are vital in developing a constructive approach to deal with growing antibiotic resistance (2). The study aims to describe the population based antibiotic prescriptions among patients attending primary care centers in Qatar. Methodology: A population based observational study of all medications prescribed in the all Primary Health Care Centers during the period of 2017-2018 in Qatar. Records with all medication prescriptions were extracted and linked to medical diagnosis. Antibiotics prescriptions records were compared to non- antibiotics records using logistic regression model in identifying the potential predictors for antibiotic prescriptions. Results: A total of 11,069,439 medication prescriptions given over a period of two-years, we found about 12.1% (n= 726,667) antibiotics prescriptions were antibiotics, and 65% of antibiotics are prescribed and received by the patients at the first visits. Paracetamol (22.3%) was the first highest medication prescribed followed by antibiotics (12.1 %) and vitamin D2 (10.2 %). More than half of all antibiotics prescribed during the period of January 2017 to December 2018 were Penicillin (56.9%). We found that half of the antibiotics (49.3 %) have been prescribed for the respiratory system comparing to the other body system. We found that males were 29% more likely be given an antibiotic compared to females (OR=1.29, 95% CI= 1.24- 1.33). Implications: The study provides a baseline data to enable PHCC management to design effective intervention program to address the problem of antibiotics resistance. Furthermore, it will help the policymakers to comprehend the size of the issue and develop a system to manage the antibiotics therapy. Conclusion: Antibiotics was the second highest medication prescribed in the Primary Health Care Centers in Qatar after paracetamol and most of the patients received it at the first visit. Most of the prescriptions in Primary Health Care Centers in Qatar were for the respiratory system, and Penicillin was the highest class prescribed. Male visitors were prescribed antibiotics more than female visitors.
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Abdulrhim, Sara Hamdi, Mohamed Izham Mohamed Ibrahim, Sowndramalingam Sankaralingam, Mohammed Issam Diab, Mohamed Abdelazim Mohamed Hussain, Hend Al Raey, Mohammed Thahir Ismai, and Ahmed Awaisu. "The Perspectives of Healthcare Professionals and Patients on the Value of Collaborative Care Model for Diabetes in Primary Healthcare settings in Qatar." In Qatar University Annual Research Forum & Exhibition. Qatar University Press, 2020. http://dx.doi.org/10.29117/quarfe.2020.0178.

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Background: Diabetes mellitus (DM) is one of the top health priorities in Qatar due to its high prevalence of 15.5%, which is projected to increase to 29.7% by 2035. DM management is still challenging despite healthcare advancement, warranting the need for a comprehensive Collaborative Care Model (CCM). Therefore, we aim to evaluate the value of CCM in DM care at a primary healthcare (PHC) setting in Qatar. Methodology: This study was a qualitative exploration of healthcare professionals’ (HCPs’) and patients’ perspectives on the value of CCM provided at the center. Twelve patients and twelve HCPs participated in semi-structured one-toone interviews. Qualitative data were analyzed and interpreted using a deductive coding thematic analysis process. Results: The interviews resulted in 14 different themes under the predefined domains: components of CCM (five themes), the impact of CCM (three themes), facilitators of CCM provision (three themes), and barriers of CCM provision (three themes). The majority of the participants indicated easy access to and communication with HCPs at QPDC. Participants appreciated the extra time spent with HCPs, frequent follow-up visits, and health education, which empowered them to self-manage DM. Generally, participants identified barriers and facilitators related to patients, HCPs, and healthcare system. Conclusion: The providers and users of CCM had an overall positive perception and appreciation of this model in PHC settings. Barriers to CCM such as unpleasant attitude and undesirable attributes of HCPs and patients, unsupportive hospital system, and high workload must be addressed before implementing the model in other PHC settings.
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Cassak, David. "Technology's challenge: technology adoption in a managed care environment for health care product companies." In Health Care Technology Policy II: The Role of Technology in the Cost of Health Care: Providing the Solutions, edited by Warren S. Grundfest. SPIE, 1995. http://dx.doi.org/10.1117/12.225346.

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Shahedi, Sara, Alfredo Augusto Vieira Soeiro, and Sara Maheronnaghsh. "A framework to implement Occupational health and safety innovation." In 4th Symposium on Occupational Safety and Health. FEUP, 2021. http://dx.doi.org/10.24840/978-972-752-279-8_0043-0048.

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Background and objectives: Being able to compete in the market needs sustainable development. Occupational safety and health Innovation process is one of the most important procedures helping companies to achieve their goal and to win the competition as radical change in the workers’ environment, enhancing the profitability of companies. However, most research and discussion of innovations are focused on product development and/or process improvement, disregarding workplace and service innovation. This study will outline the general terms related to safety innovation and how the process can get managed using some techniques to implement a framework in a company. In this case, the objectives of the study are to introduce the innovation in OHS and to introducea model including some techniques for industries to apply innovation in occupational safety and health. Methodology: To apply Innovation in occupational safety and health, the first step is to indicate the importance of innovation. To do so, a major review of studies focusing on occupational safety and health and innovation were required. The second step in this part is to define a frame work for innovation in safety and health, by reviewing those introduced frameworks in both innovation and health and safety researches. Results and conclusions: As a result, the importance of innovation has been searched and emphasized. On the other hand, a 6 step framework has been introduced and the details of applying the framework has been expanded. The frame work employs 6 continues steps starting by TIPS technique which is followed by JTBD. Based on the result, the framework can be applied. The introduced steps are as follow: Identifying Innovation Projects, Scoping and Focusing Innovation Projects, Leveraging Brainpower and Turbo-Charging Creativity, Selecting the Best Ideas for Further Development and Design, Evaluating How New Products/Services Perform Prior to Their Release, Problem Diagnosis and Improvement Prior to Commercialization. Following these steps as a framework may increase the efficiency of the company however, there is a huge need of several case studies in long term to assess the result and to compare the efficiency of the introduced framework.
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Saha, Pamela, and Subrata Saha. "Impact of managed care on the development of new medical technology: ethical concerns." In Health Care Technology Policy II: The Role of Technology in the Cost of Health Care: Providing the Solutions, edited by Warren S. Grundfest. SPIE, 1995. http://dx.doi.org/10.1117/12.225342.

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Yi, Xueyuan, and Qinlan Zhang. "Health Care Personnel's Mental Health Echelon Management Model Research." In 2017 2nd International Conference on Education, Sports, Arts and Management Engineering (ICESAME 2017). Paris, France: Atlantis Press, 2017. http://dx.doi.org/10.2991/icesame-17.2017.378.

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Maskat, Ruhaila, Shariza Abdul Razak, and Mohd Firzan Shamsudin. "A Semistructured Data Approach to Heterogeneous Health Plan Data in Malaysian Managed Care Organizations." In 2009 International Conference on Information Management and Engineering. IEEE, 2009. http://dx.doi.org/10.1109/icime.2009.54.

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Benz, Jason M., Kevin A. Distelhurst, Douglas B. Hunt, and Rick Kontra. "Implementation of a Visual System to Manage and Improve Failure Analysis Work Flow." In ISTFA 2015. ASM International, 2015. http://dx.doi.org/10.31399/asm.cp.istfa2015p0245.

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Abstract Many articles and books have been written that discuss and study the techniques of lean thinking and methodologies. The applications of these methodologies have included such industries as manufacturing, health care, and information technology. Application to analytical laboratories has been rare or non-existent due to the inability to apply lean methodologies to a process with ‘unique’ analytical work flows as well as a lack of a direct connection to the manufacturing value stream. The following paper describes the work done in a semiconductor failure analysis laboratory to visualize work flow, design a forecasting model, and create a management system. The result of which has been sustained and improved quality, resource utilization, and delivery of actionable root cause failure analysis.
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Vlahu-Gjorgievska, Elena, and Vladimir Trajkovik. "Towards Collaborative Health Care System Model - COHESY." In 2011 IEEE International Symposium on "A World of Wireless, Mobile and Multimedia Networks" (WoWMoM). IEEE, 2011. http://dx.doi.org/10.1109/wowmom.2011.5986197.

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Reports on the topic "Managed health care model"

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Layton, Timothy, Alice Ndikumana, and Mark Shepard. Health Plan Payment in Medicaid Managed Care: A Hybrid Model of Regulated Competition. Cambridge, MA: National Bureau of Economic Research, June 2017. http://dx.doi.org/10.3386/w23518.

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Baker, Laurence, and Martin Brown. The Effect of Managed Care on Health Care Providers. Cambridge, MA: National Bureau of Economic Research, April 1997. http://dx.doi.org/10.3386/w5987.

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Baker, Laurence, and Sharmila Shankarkumar. Managed Care and Health Care Expenditures: Evidence From Medicare. Cambridge, MA: National Bureau of Economic Research, September 1997. http://dx.doi.org/10.3386/w6187.

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Frank, Richard, Jacob Glazer, and Thomas McGuire. Measuring Adverse Selection in Managed Health Care. Cambridge, MA: National Bureau of Economic Research, December 1998. http://dx.doi.org/10.3386/w6825.

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Frank, Richard, and Thomas McGuire. Parity for Mental Health and Substance Abuse Care Under Managed Care. Cambridge, MA: National Bureau of Economic Research, December 1998. http://dx.doi.org/10.3386/w6838.

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Baker, Laurence, and Ciaran Phibbs. Managed Care, Technology Adoption, and Health Care: The Adoption of Neonatal Intensive Care. Cambridge, MA: National Bureau of Economic Research, September 2000. http://dx.doi.org/10.3386/w7883.

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Kaestner, Robert, Lisa Dubay, and Genevieve Kenney. Medicaid Managed Care and Infant Health: A National Evaluation. Cambridge, MA: National Bureau of Economic Research, May 2002. http://dx.doi.org/10.3386/w8936.

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Baker, Laurence. Managed Care and Technology Adoption in Health Care: Evidence from Magnetic Resonance Imaging. Cambridge, MA: National Bureau of Economic Research, November 2000. http://dx.doi.org/10.3386/w8020.

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Korody-Colwell, Carol A. The Healthcare Administrator's Desk Reference: A Managed Care and Health Care Contracting Dictionary for the Military Health System. Fort Belvoir, VA: Defense Technical Information Center, July 1998. http://dx.doi.org/10.21236/ada420803.

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Brisson, Anne, Richard Frank, Elizabeth Notman, and Julie Gazmararian. Impact of a Managed Behavioral Health Care Carve-Out: A Case Study of One HMO. Cambridge, MA: National Bureau of Economic Research, October 1997. http://dx.doi.org/10.3386/w6242.

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