Financing for the Reorganization of Medical Care Services and Their Delivery

1972 ◽  
Vol 50 (4) ◽  
pp. 191 ◽  
Author(s):  
I. S. Falk
Keyword(s):  
Medical Care ◽  
Care Services

Les Nouveaux Miserables: Modem Victims of Social Asphyxia

PEDIATRICS ◽  
1995 ◽  
Vol 96 (4) ◽  
pp. 851-857
Author(s):  
David R. Smith
Keyword(s):  
Health Care ◽  
Health Status ◽  
Medical Care ◽  
Health Care Costs ◽  
Health Care Services ◽  
Preventive Services ◽  
Medical Care System ◽  
Care Services ◽  
Care Costs ◽  
Care System

During the past 30 years, social and economic barriers to health care services have increased for many Americans, especially for the nation's most vulnerable populations. Health status actually has declined for certain populations during this time. Meanwhile, national attention has been focused primarily on containing health care costs and on devising strategies for reforming the financing of health care rather than strategies for achieving improvements in the health status of the population. Existing methods of financing health care services, health research priorities, the increasing centralization and compartmentalization of health care services, and the recent failure of national health reform all serve to hinder this nation's progress towards developing a comprehensive and accountable health care system focused on promoting and achieving improved health as well as treating sickness. Recent changes in the health care marketplace, however, including a growing movement toward measuring the outcomes of medical treatments and an emphasis on improving the quality of services, have increased interest among payers and providers of health care services in investing in preventive services. Health maintenance organizations and other integrated health care delivery systems are beginning to devise incentives for increasing preventive care as well as for containing costs. The transformation of the nation's current medical care system into a true health care system will require innovative strategies designed to merge the existing fragmented array of services into coordinated and comprehensive systems for delivering primary and preventive health care services in community settings. The community-Oriented Primary Care concept successfully blends these functions and has achieved measurable results in reducing health care costs and improving access to preventive services for identified populations. There is flexibility in existing funding sources to promote preventive services in various public and private health care settings and to assist in the transformation from a disease-oriented medical care system to one focused on health.

The Role of the Primary Care Physician in the Care of Children with Serious Heart Disease

PEDIATRICS ◽  
1994 ◽  
Vol 94 (3) ◽  
pp. 284-290
Author(s):  
Paul C. Young ◽  
Yu Shyr ◽  
M. Anthony Schork
Keyword(s):  
Primary Care ◽  
Heart Disease ◽  
Chronic Illness ◽  
Medical Care ◽  
Primary Care Physician ◽  
Primary Care Physicians ◽  
Care Physician ◽  
Care Needs ◽  
Care Services ◽  
Primary Care Services

Objective. To determine the roles of primary care physicians and specialists in the medical care of children with serious heart disease. Setting. Pediatric Cardiology Division; Tertiary Care Children's Hospital. Subjects. Convenience sample of parents, primary care physicians, and pediatric cardiologists of 92 children with serious heart disease. Design. Questionnaire study; questionnaires based on 16 medical care needs, encompassing basic primary care services, care specific to the child's heart disease and general issues related to chronic illness. Results. All children had a primary care physician (PCP), and both they and the parents (P) reported high utilization of PCP for basic primary care services. However, there was little involvement of PCP in providing care for virtually any aspect of the child's heart disease. Parents expressed a low level of confidence in the ability of PCP in general or their child's own PCP to meet many of their child's medical care needs. Both PCP and pediatric cardiologists (PC) were significantly more likely than parents to see a role for PCP in providing for care specific to the heart disease as well as more general issues related to chronic illness. PC and PCP generally agreed about the role PCP should play, although PC saw a bigger role for PCP in providing advice about the child's activity than PCP themselves did. PC were less likely to see the PCP as able to follow the child for long term complications than PCP did. PC were more likely than PCP to believe that PCP were too busy or were inadequately reimbursed to care for children with serious heart disease. Only about one-third of parents reported discussing psychosocial, family, economic, or genetic issues with any provider, and PCP were rarely involved in these aspects of chronic illness. Conclusions. Primary care physicians do not take an active role in managing either the condition-specific or the more general aspects of this serious chronic childhood illness. With appropriate information and support from their specialist colleagues primary care physicians could provide much of the care for this group of children. Generalists and specialists are both responsible for educating and influencing parents about the role primary care physicians can play in caring for children with serious chronic illness.

MEDICAL CARE AND HOME CARE SERVICES

1968 ◽  
Vol 17 (6) ◽  
pp. 569
Author(s):  
R. M. COE ◽  
E. A. FRIEDMANN ◽  
R JACK SIGLE ◽  
L DOUGLAS MARSHAL ◽  
H. P. BREHM ◽  
...  
Keyword(s):  
Home Care ◽  
Medical Care ◽  
Home Care Services ◽  
Care Services

scholarly journals Filling Gaps and Setting Boundaries: Examining Utilization of Health and Social services at JeffHOPE Student Run Clinics

2021 ◽  
Vol 12 ◽  
pp. 215013272110375
Author(s):  
Roy Wang ◽  
Amanda Guth ◽  
Alyssa Tate ◽  
Michele Ly ◽  
James Plumb
Keyword(s):  
Primary Care ◽  
Medical Care ◽  
Social Services ◽  
Chart Review ◽  
Retrospective Chart Review ◽  
Patient Survey ◽  
Care Services ◽  
Primary Care Services ◽  
Clinic Site ◽  
Care Gaps

The objective of this study was to describe the frequency that healthcare and social support services offered by JeffHOPE, a student run clinic for people experiencing homelessness in Philadelphia, PA, were utilized by patients. This study also aimed to investigate where patients would seek medical care on a given day had they not been able to access JeffHOPE. This study was conducted via mixed methods consisting of retrospective chart review of patient encounter records and a patient survey conducted weekly throughout 2019, both at a single clinic site, and retrospective chart review of January through March 2020 records at 5 clinic sites. This study found that the frequency of services utilized varied between clinic sites, and that Pharmacy and Procedure committees were the most utilized when examining the combined clinic data. Additionally, the survey found that JeffHOPE provided medical care to those that otherwise would not have sought it. Clinics also served as an alternative to accessing care for non-emergent issues in an Emergency Department (ED) for some patients, but for others it replaced seeing their primary care provider (PCP). This study confirmed that the services offered by JeffHOPE are well-utilized by patients experiencing homelessness in Philadelphia. It also revealed that while the organization’s medical services filled care gaps and potentially decreased unnecessary ED visits, they were also sometimes accessed in lieu of a PCP visit. A focused effort on linkage to formal primary care services for all JeffHOPE patients and expanding collection of more granular data to all clinics represent important future endeavors for this student run organization.

scholarly journals Why Patients Dissatisfy with Medical Care in China--Evidence from the Patient Perceived Value

2020 ◽  
Author(s):  
Hui Qian ◽  
Wu Lu ◽  
Daliang Zhang
Keyword(s):  
Medical Care ◽  
Perceived Value ◽  
Young Female ◽  
Care Quality ◽  
High Educational Level ◽  
Health Care Environment ◽  
Patients Satisfaction ◽  
Care Services ◽  
And Performance ◽  
Waiting Line

Abstract - Background: Enlarged financial and managerial resources spending on medical improvement had rarely to decrease the crowed waiting line or increase the patient satisfaction. Investigating patients’ perceived value (PPV) gain an insight of patients’ satisfaction. PPV is a valuable perspective for hospitals to strategically improve medical care quality and performance from functional and emotional sides. - Methods: According to the theory of perceived value, an empirical study had been carried out by field survey and data collection in 7 well-known hospitals in Zhejiang Province China. 2586 questionnaires with valid data were analyzed according to PPV.- Results: Beside of the importance of functional values (effectiveness of treatment effect, reasonable and accurate prices, standardization and normalization, convenience and accessibility), the emotional values (communication with doctors/nurses, comfortable environment and facilitates) were highlighted. The preferences of patients’ perceived value were influenced by patients’ background features, and then the differentiation of patients’ satisfaction was proceeded. These patients, who are young, female, outpatient, light ill condition, high educational level and high income, tend to be relatively high demanding on medical care services but in high dissatisfaction level. Additionally, the findings show an advantage to pass the reasonability of waiting time to patients’ thought.- Conclusion: Classified convenience receiving approaches according to differentiated PPV and background features of patients, equipped up with e-enabled health care environment, can bring worthwhile patients’ satisfaction in Chinese hospitals .

Structure of Medical Care Services in the U.S.S.R.

1972 ◽  
Vol 2 (2) ◽  
pp. 239-242
Author(s):  
J. Fry
Keyword(s):  
Health Services ◽  
Medical Care ◽  
Rural Areas ◽  
Free Choice ◽  
Work Load ◽  
Master Plan ◽  
Medical Assistants ◽  
Occupational Physicians ◽  
Care Services ◽  
Primary Physicians

The health services of the U.S.S.R. are organized and administered on a master plan based on central and monolithic planning according to Marxist socioeconomic principles. The health services have provided good available and accessible medical care to all its peoples. This has been a great and remarkable achievement. Primary medical services in the U.S.S.R. are provided by a series of specialists— uchastok (neighborhood) pediatricians, therapists (internists), occupational physicians, and dentists. Each has an allocated geographic locality and there is no free choice of physician. The uchastok physicians work from polyclinics with specialists. They also carry out daily home visits. There are no hospital facilities. The nature of the work and the work load is similar to that of primary physicians in other systems. In rural areas because of dispersal of populations, primary medical care is carried out by medical assistants (feldshers) who work under the supervision of physicians.

Performance Evaluation of the Combination of Medical Care and Old-age Service in Old-age Institutions in China: A Two-stage DEA Approach

2020 ◽  
Author(s):  
Na Du ◽  
Man Yuan ◽  
Peng Wu ◽  
Zhiwu Li
Keyword(s):  
Performance Evaluation ◽  
Medical Care ◽  
Old Age ◽  
Elderly Care ◽  
Evaluation Index System ◽  
Evaluation Index ◽  
Two Stage ◽  
Care Services ◽  
Performance Evaluation Index ◽  
A Performance

Abstract Background: In the context of China’s aging population, comprehensive medical care, convenient diagnosis, comprehensive medical care and elderly care services are increasingly needed. But China's medical care and elderly care service system is still immature. This study aims to build a performance evaluation index/criteria system for the combination of medical care and elderly care services and present an empirical approach to assess them.Methods: A two-stage DEA approach is taken: 1) establish a performance evaluation index system for the combination of medical care and elderly care services, 2) adopt a two-stage DEA to evaluate the performance of 30 pension institutions in China, and 3) Determine and identify important criteria to improve the efficiency of pension institutions. Results: The results show that the two-stage DEA accounted for a relatively high affiance of medical and nursing care services, but resource allocation still needs to be further optimized. Institutions with ineffective DEA need to reduce the five factors of operations, management, fixed assets, technology and services in the input dimension. In the output dimension, the service evaluation effect and safety management effect need to be improved. The performance of combined old-age care and medical care in old-age institutions can be improved in terms of investment in fixed assets, methods of capital subsidies, supervision and management, as well as standardized operations.Conclusions: This study establish a performance evaluation index system for the combination of medical care and elderly care services and present a two-stage DEA empirical approach to evaluate the performance of 30 pension institutions in China, which provides the method supports for decision-makers and researchers in performing evaluation of pension institutions in China, outlines the suggestions in improving them.

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