Managed care: reshaping the future

Article Abstract:

Today decisions regarding the delivery of health care are increasingly being made in the board rooms of corporations. Managed care allows the employer to manage health care costs in a fashion similar to other business expenses. Typically managed care gives the employee the option of using a 'network' physician at a lower cost (to the patient) than if he goes outside and chooses his own physician. It is predicted that by 1992 managed care alternatives will dominate national enrollment. The traditional indemnity-type health insurance is becoming obsolete, and the insurance companies are switching to becoming preferred provider organizations. Managed care programs in the future may be adopted by Medicare and used to provide medical care to the poor and medically uninsured. There is expected to be a significant decrease in hospital use; in 1981 1,214 days were used per 1,000 patients, yet by 1995 this is expected to fall to 400 days per 1,000 patients. The managed care programs have a significant impact on chiropractic care. Managed health care plans may not fall under the traditional "insurance" and the protection provided by state insurance laws related to fully insured medical care insurance may not apply. In one large company employees could choose a fee-for-service insurance plan with the insurance paying 80 percent and the patient 20 percent of medical costs, or else they could opt for a preferred provider organization which paid 90 percent, and patient 10 percent. However, no chiropractor was considered eligible for participation in the preferred provider organization; only participants with hospital privileges were eligible. The American Chiropractic Association has formed a task force on managed care to develop solutions for consideration by the association. (Consumer Summary produced by Reliance Medical Information, Inc.)

Influence, Managed care plans (Medical care)

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Chronic otitis media: a case report

Article Abstract:

Otitis media is an inflammation of the middle ear. Approximately 85 percent of all children have an episode of otitis media at least once, and it is estimated that 30 million people with otitis media seek medical attention each year. The total cost of these visits is estimated to be in excess of $1 billion. The standard medical treatment for this condition is antibiotic therapy. When drug treatment fails and the condition does not go away by itself, surgery is performed to insert a tube into the inner ear that is used to drain fluid out of the ear. Roughly 500,000 to 2 million of these operations are performed each year. This article describes the case report of a 38-year-old woman who had chronic otitis media and hearing loss, and received chiropractic treatment for her condition. The woman was being treated by a chiropractor for headaches and colitis (inflammation of the colon). She had a six-month history of progressive hearing loss, and was diagnosed as having chronic otitis media by an otolaryngologist, who prescribed antibiotics. She refused to have surgery to drain the affected ear, and continued to visit her chiropractor where she received five cranial adjustments over a three- to four-month period. The patient could feel improvement after each adjustment, and after her fourth adjustment the patient reported that her ears "opened up". The authors conclude that these findings indicate the cranial adjustments corrected the otitis media. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Care and treatment, Usage, Case studies, Otitis media, Manipulation (Therapeutics), Orthopedic manipulation, Cranial manipulation

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