RESUMEN
The financing of asthma care is the third topic of the National Asthma Education and Prevention Program Task Force Report on the Cost Effectiveness, Quality of Care, and Financing of Asthma Care. This working group explored the effects of financing on access to services, treatment of asthma, and potential health outcomes. Over the course of a year, the working group collected and analyzed information pertaining to the various types of public and private health care financing mechanisms, including both insurance-based and non-insurance-based issues. The group examined the published literature and gathered information from four public hearings conducted across the nation. The result of this synthesis of information on health care financing and asthma care is a set of 12 recommendations that seek to improve the financing of asthma care.
Asunto(s)
Asma/economía , Seguro de Salud , Asistencia Médica , Asma/terapia , Humanos , Estados UnidosRESUMEN
Cystic fibrosis is an expensive chronic illness that has not historically demonstrated cost savings and quality of care improvement potential by alternate care plans using comprehensive disease management treatment modalities. This case study describes care provided over a 45-month period to an adolescent female with severe cystic fibrosis involving multiple hospitalizations and $396,000 in total cost of care. Treatment plans before and after the initiation of a comprehensive home care disease management program are described. Clinical improvement outcomes and savings of 33.4% in total costs were documented using longitudinal analysis of paid claims data and medical chart review. Guidelines are suggested for case managers desiring to initiate similar programs of care.
Asunto(s)
Manejo de Caso/economía , Fibrosis Quística/economía , Manejo de la Enfermedad , Adolescente , Ahorro de Costo , Fibrosis Quística/terapia , Femenino , Costos de la Atención en Salud , Servicios de Atención de Salud a Domicilio/economía , Hospitalización/economía , Humanos , Evaluación de Resultado en la Atención de SaludAsunto(s)
Servicios de Atención de Salud a Domicilio/normas , Evaluación de Resultado en la Atención de Salud , Centers for Medicare and Medicaid Services, U.S. , Servicios de Atención de Salud a Domicilio/organización & administración , Joint Commission on Accreditation of Healthcare Organizations , Satisfacción del Paciente , Atención Dirigida al Paciente , Garantía de la Calidad de Atención de Salud , Integración de Sistemas , Estados UnidosRESUMEN
On Jan. 1, 1991, the John Hancock National Transplant Program (JHNTP) became operational, matching kidney, heart, liver, and bone marrow transplant patients from a potential pool comprising more than two million covered lives, with organ transplant programs at 14 institutions across the country. Conceptualizing the program and selecting and contracting with the transplant centers took more than 18 months. This article shares some of the insights from that process that are pertinent to providers of transplant services and to others considering entering this or other forms of specialized contracting.
Asunto(s)
Hospitales Especializados/normas , Seguro Quirúrgico/normas , Trasplante de Órganos/normas , Calidad de la Atención de Salud , Propuestas de Licitación/organización & administración , Ahorro de Costo , Recolección de Datos , Trasplante de Órganos/economía , Técnicas de Planificación , Evaluación de Programas y Proyectos de Salud , Estados UnidosRESUMEN
Some employers spend half their health benefits dollars on outpatient care. Utilization of ambulatory services is up, costs-per-case are escalating fast--with some procedures demonstrably costing 85%-95% of inpatient charges--and providers' profits are increasing. Executives of the Health Data Institute and The Associated Group describe a multi-pronged approached to managing the burgeoning costs of a health care delivery alternative that was supposed to save employers money.