Resource guide for quality and cost management

Article Abstract:

A list of resources that are concerned with the management of medical care costs is provided. Information concerning health care coalitions (176 in the US), health maintenance organizations (10 main organizations), and preferred provider organizations (listing the 10 largest), is presented. Groups carrying out research on health care costs are briefly described. The groups include the RAND Corporation, the Medical Treatment Effectiveness Program, the Diagnostic and Therapeutic Technology Assessment (DATTA) of the American Medical Association (AMA), the National Center for Health Services Research, and the Health Care Financing Administration, which administers programs of the Professional Review Organization. A booklet called Attributes to Guide the Development of Practice Parameters, put out by the Office of Quality Assurance of the AMA, discusses the formulation of practice parameters (guidelines for physicians regarding the ways certain clinical situations should be handled). A list of practice parameter reports that have been prepared by different associations is presented. Treatment recommendations can also be obtained from disease-specific voluntary organizations, such as the American Cancer Society or National Kidney Foundation. Addresses are provided for five such groups. Other health-related organizations are also listed, as are relevant publications (journals and books). The schedule of DATTA evaluations appears in the Appendix. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Management, Resource allocation, Physician services utilization

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International comparisons of health care expenditures and satisfaction

Article Abstract:

A summary of the results from a study of health care in 10 industrial countries is presented in graphical form, with a brief commentary. People in the US seem less satisfied with their health care system than inhabitants of the other countries (Canada, the Netherlands, West Germany, France, Australia, Sweden, Japan, England, and Italy), with only 10 percent agreeing with the statement that the health care system works well, needing only minor repairs. Satisfaction rates in selected other nations were 56 percent for Canada and 29 percent for Japan; Italy was closest to the US, with a 12 percent satisfaction rate. Interestingly, though, the US has the highest level of spending per person per year ($2,051). In comparison, Great Britain was the lowest ($758), and no other country exceeded $1,483 (the level of spending in Canada). Americans appear beset by fear when it comes to health care: fear that they will lose benefits if they lose a job, fear that their benefits will be inadequate, and fear of out-of-pocket expenses. These factors, according to the authors of the study, are more important in generating dissatisfaction than many characteristics of the health care system usually considered influential. The study can be found in the Summer 1990 issue of Health Affairs: its title and authors are, respectively, Satisfaction with health systems in ten nations, by R.J. Blendon, R. Leitman, I. Morrison, and K. Donelan. (Consumer Summary produced by Reliance Medical Information, Inc.)

Australia, Canada, Europe, Japan, International aspects

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Reducing malpractice costs

Article Abstract:

The increasing incidence of malpractice claims has driven medical practice insurance premiums into the five-plus figure range. The major causes of the increase in malpractice claims include poor communication between physician and patient, not practicing medicine for the benefit of the patient, and failure to refer the patient to a specialist. These issues concern not only the practicing physician and the patient, but also the providers of health care plans. With recent court rulings, health maintenance organizations and other managed care organizations are being held responsible for the quality of the medical care that they provide for patients enrolled in the program. By altering their methods of medical practice, physicians can reduce the costs associated with and the incidence of malpractice suits. Suggested ways in which physicians can reduce malpractice costs include keeping proper patient medical histories, reevaluating diagnostic strategies, awareness of the proper use, sensitivity, and limits of diagnostic tests that are used, and clearly defining the medical problem, diagnosis, and objectives of treatment for each patient. (Consumer Summary produced by Reliance Medical Information, Inc.)

Finance, Physicians, Medical professions, Insurance, Malpractice insurance

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