Approaches to the measurement of effectiveness and efficiency in medical care: the use by employers of community-wide population-based patterns of care
Article Abstract:
Clinicians think of individual patients, when they think of medical care; many others in the health care field (public policy makers, epidemiologists, insurance executives, hospital and health maintenance organization managers) think in terms of defined population groups. These different frames of reference contribute importantly to the misunderstandings that develop between clinicians and health care managers, creating a communications gap that must be bridged. Since cooperation on the part of local medical communities is essential before any efforts at cost-containment can work, several points that can facilitate such cooperation should be noted. Results presented to clinicians from studies of large groups of people need to be presented in a clinically meaningful manner. Population-based studies (aimed at clearly defined populations to survey the ways in which they consume medical care) are essential for answering some questions; these are discussed. Examples from the General Electric (GE) Corporation are used to illustrate how the population-based approach solved problems affecting one GE division. In this case, per capita medical charges for cesarean sections were much higher in Utica than Syracuse, although the per case rate was actually less. This was due to the fact that the two regions had different rates of cesarean section procedures. Variations in use rates of medical care can differ between populations because the groups actually differ in illness rates or access to care, or because physicians treating the two populations have different practice styles. These issues, and their implications for medical care costs, are evaluated in detail. Variations in use rates can also be equalized by better standardization of diagnostic and treatment approaches. Epidemiologic surveillance methods offer an appropriate, effective mechanism to improve communication between managers and clinicians. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Journal of Occupational Medicine
Subject: Health care industry
ISSN: 0096-1736
Year: 1990
User Contributions:
Comment about this article or add new information about this topic:
The chiropractic and me: Whither? Whether?
Article Abstract:
The frequent dispute between physicians providing traditional medical care and chiropractors is discussed in terms of an article on the relative costs of treating occupational injuries, particularly low back injuries. A review of 150 reported trials and studies of traditional care practices in the treatment of low back pain and injuries reveals the lack of success in the treatment of these conditions. Continued unsuccessful use of untried and unverified new treatments and potions in their the care and treatment is unwarranted. While chiropractors may achieve modest success in treating the mildest of these conditions with their various techniques and manipulations, the ultimate determination of the success or failure of any intervention is how the patient feels. The professional dispute today is primarily a jealous guarding of the health care dollar, an unwillingness to share, despite the feelings of the patient receiving the care. The ultimate decision should rest on benefit to the patient. The opinions of lawmakers notwithstanding, and certainly without consideration for the financial rewards accruing to the provider, the dispute between physicians and chiropractors should be resolved. Treating and caring for the patient should be paramount. The reward mechanism to the provider should be modified to meet that criterion. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Journal of Occupational Medicine
Subject: Health care industry
ISSN: 0096-1736
Year: 1991
User Contributions:
Comment about this article or add new information about this topic:
Differences between a supervised and independent strength and conditioning program with chronic low back syndromes
Article Abstract:
Forty patients suffering from long-term and severe lower back pain were treated with either supervised or unsupervised strength and conditioning programs. All patients were tested before the start of the program for aerobic fitness (heart and lung conditioning), strength, and level of back pain. Half the patients were given a predesigned exercise program and told to exercise four times a week for six months. The other patients were given the same exercise program for the same period, but a strength and conditioning specialist monitored them. The supervised patients completed 90.75 sessions out of the 96 scheduled, compared with only 31.95 for the unsupervised patients. The supervised patients experienced greater gains in strength and aerobic fitness, and larger decreases in amounts of pain and body fat than unsupervised patients. Supervision of such exercise programs increases rates of compliance and success.
Publication Name: Journal of Occupational Medicine
Subject: Health care industry
ISSN: 0096-1736
Year: 1989
User Contributions:
Comment about this article or add new information about this topic:
- Abstracts: The measurement of individual utility and social welfare. Optimal medical treatment under asymmetric information
- Abstracts: Enhancing operational efficiency in a health care organization. part 2 A strategic approach to service quality: a field study in a rural health care setting
- Abstracts: Tobacco use: selection, stress, or culture? A review of medical surveillance records of employees exposed to ethyleneamines
- Abstracts: Adaptation of the Centers for Disease Control guidelines for the prevention of nosocomial infection in a pediatric intensive care unit in Jakarta, Indonesia. part 2
- Abstracts: The effects of behavioral risks on absenteeism and health-care costs in the workplace. Use of focus groups to study absenteeism due to illness