RESUMEN
Managed care offers many career opportunities to HIM professionals. If you're interested in making a transition to this area, the first step is understanding the ways HIM adds value to managed care processes. This article kicks off the first in a series on HIM opportunities in managed care.
Asunto(s)
Movilidad Laboral , Gestión de la Información/organización & administración , Programas Controlados de Atención en Salud/organización & administración , Administradores de Registros Médicos , Programas Controlados de Atención en Salud/normas , Sistemas de Registros Médicos Computarizados , Gestión de la Calidad Total , Estados UnidosAsunto(s)
Programas Controlados de Atención en Salud/normas , Auditoría Médica/organización & administración , Revisión de Utilización de Recursos/organización & administración , Benchmarking , Connecticut , Ahorro de Costo/métodos , Programas Controlados de Atención en Salud/organización & administración , Programas Controlados de Atención en Salud/estadística & datos numéricos , Auditoría Médica/métodos , Registros Médicos/normas , Objetivos Organizacionales , Técnicas de Planificación , Evaluación de Procesos, Atención de Salud , Comité de ProfesionalesRESUMEN
The health information management (HIM) profession is expanding to new sites and perspectives. The implementation of Medicare managed care has brought changes not only by emphasis on management of the individual's medical care and the cost of that care, but also by creating new uses for coded data. This article examines the evolution of risk adjustment methods in Medicare Managed Care. The current choice for risk adjustment is the Principal Inpatient Diagnostic Cost Groups (PIP-DCG). This article explains the health plan's submission of encounter data and how HIM can play a valuable role in data capture and improvement in data quality and reimbursement.
Asunto(s)
Indización y Redacción de Resúmenes/métodos , Enfermedad/clasificación , Control de Formularios y Registros/métodos , Registros Médicos/clasificación , Medicare Part C/organización & administración , Ajuste de Riesgo/métodos , Anciano , Centers for Medicare and Medicaid Services, U.S. , Humanos , Estados UnidosAsunto(s)
Planes de Asistencia Médica para Empleados/normas , Servicios de Información , Programas Controlados de Atención en Salud/normas , Calidad de la Atención de Salud/normas , Recolección de Datos/métodos , Educación Continua , Eficiencia Organizacional , Sector Privado , Sector Público , Programas Informáticos , Gestión de la Calidad Total , Estados UnidosAsunto(s)
Servicios de Información , Programas Controlados de Atención en Salud/normas , Garantía de la Calidad de Atención de Salud/organización & administración , Interpretación Estadística de Datos , Documentación , Femenino , Humanos , Masculino , Sistemas de Información Administrativa/normas , Responsabilidad Social , Estados UnidosRESUMEN
The effects of anemia during lead exposures were studied using an infant baboon animal model. When the hemoglobin concentration was reduced to less than 70% of normal, a marked blood lead increase was observed and the free erythrocyte porphyrin value, aminolevulinic acid dehydratase activity and reticulocyte counts increased. Special emphasis should be placed on nutritional effects in lead exposures.
Asunto(s)
Anemia Hipocrómica/metabolismo , Exposición a Riesgos Ambientales , Hemo/biosíntesis , Plomo , Animales , Modelos Animales de Enfermedad , Plomo/sangre , Papio/metabolismoRESUMEN
The results of this work demonstrate that a significant exposure to one of several lead compounds can be detected by the ALAD test without a concomitant rapid increase in blood lead concentration. Use of the ALAD test may effectively demonstrate the occurrence of excessive exposure at an earlier time than possible by the accepted blood or urine lead concentration measures. By comparing "early" and "steady state" values of PbB and ALAD, it was possible to derive an equation which can be used to determine an ultimate (steady state) value of PbB from an early (short-term) ALAD measurement. Re-examination of workplace atmospheres would be indicated by findings of depressed ALAD activity in the absence of elevated blood lead values. This could occur when sporadic lead exposures are occurring or upon initiation of a period of continuing elevated exposures. Thus, corrective action can be requested and taken prior to the point at which an excessive blood lead value would be found. Further studies of industrial groups are indicated to confirm the usefulness of the test for the purposes suggested.
Asunto(s)
Eritrocitos/enzimología , Hidroliasas/sangre , Intoxicación por Plomo/sangre , Porfobilinógeno Sintasa/sangre , Acetatos/administración & dosificación , Administración Oral , Animales , Carbonatos/administración & dosificación , Dieta , Modelos Animales de Enfermedad , Exposición a Riesgos Ambientales , Haplorrinos , Inyecciones Intravenosas , Plomo/administración & dosificación , Plomo/sangre , Compuestos Organometálicos/administración & dosificación , Papio , Espectrofotometría AtómicaRESUMEN
In an effort to define the toxicology and disposition of lead compounds that presently exist in paint (i.e., organic driers), a controlled dose feeding study was initiated early this year with the use of 28 infant baboons as experimental animals. The infant baboon, established as a metabolic model for a child ingesting lead, will be used to determine the adequacy of present as well as recently recommended limitations for lead in paint to assure protection from this potential source of lead exposure. To accomplish this goal, research has been designed to determine basic dose-response relationships in animals ingesting constant daily doses of a dried paint, a lead octoate drier, and lead acetate. Doses for these compounds have been chosen to cover a broad range of concentrations including that recommended by the American Academy of Pediatrics from the maximum daily permissible lead ingestion, and associated estimates of paint intake by children with pica. PARAMETERS OF METABOLIC RESPONSE FOR EACH LEAD COMPOUND, INCLUDE: general clinical surveillance, lead concentrations in blood, urine and feces, erythrocytic delta-aminolevulinic acid dehydratase and free erythrocytic porphyrin. The response of several of these measures of lead exposure as a function of time will be discussed for each compound at the several dose levels administered.