06064nam 2200757 a 450 991081152560332120240416235052.00-309-17507-01-280-19177-597866101917720-309-59674-20-585-08538-2(CKB)110986584751958(OCoLC)43475712(CaPaEBR)ebrary10057000(SSID)ssj0000119841(PQKBManifestationID)11143398(PQKBTitleCode)TC0000119841(PQKBWorkID)10073925(PQKB)10848717(MiAaPQ)EBC3376723(Au-PeEL)EBL3376723(CaPaEBR)ebr10057000(CaONFJC)MIL19177(OCoLC)923265664(EXLCZ)9911098658475195819970117d1996 uy 0engurcn|||||||||txtccrChanging health care systems and rheumatic disease /Committee on Changing Health Care Systems and Rheumatic Disease, Division of Health Care Services, Institute of Medicine, Frederick J. Manning and Jeremiah A. Barondess, editors1st ed.Washington, D.C. National Academy Press19961 online resource (252 p.) Bibliographic Level Mode of Issuance: Monograph0-309-05683-7 Includes bibliographical references.Changing Health Care Systems and Rheumatic Disease -- Copyright -- Preface -- Contents -- 1 Introduction -- CHANGING HEALTH CARE SYSTEMS -- CHRONIC DISEASE -- RHEUMATIC DISEASE -- PRACTICES AND ACHIEVEMENTS OF MANAGED CARE SYSTEMS -- Hospital Use -- Physician Use -- Tests and Procedures -- Home Health and Skilled Nursing Care -- Social/Health Maintenance Organizations -- WORK FORCE ISSUES -- RESEARCH, EDUCATION, AND TRAINING -- THE WORKSHOP -- 2 Opening Remarks -- 3 Keynote Address -- CHANGING HEALTH CARE -- HOSPITALS -- MANAGED CARE -- PHYSICIAN PAYMENT -- SPECIALIST-GENERALIST INTERACTION -- POLICY ISSUES -- 4 What Would Ideal Care Look Like? -- INTRODUCTION -- INVITED ADDRESS -- INVITED REACTION -- INVITED REACTION -- INVITED REACTION -- The Patient -- The Role of The Physician and the Relationship Between the Primary Care Provider and the Specialist -- Other Elements in An Ideal System of Care -- Rehabilitation -- Exercise -- Nonrestrictive Drug Formularies -- Alternative Delivery Mechanisms -- Structured Care -- Relationship Between Financing and Care -- Measurement of Outcomes in an Ideal Care System -- Access to an Ideal Care System -- Conclusion -- DISCUSSION -- 5 Managed Care and Rheumatoid Arthritis: Utilization and Outcomes Over 11 Years -- INTRODUCTION -- INVITED ADDRESS -- Literature on Health Care Utilization and Outcomes in FFS and HMOs -- Study Design -- Results -- Health Care Utilization -- Health Outcomes -- Summary of FFS-PGP Comparisons -- Comparisons of Care Provided by Rheumatologists and Nonrheumatologists -- Conclusions -- INVITED REACTION -- INVITED REACTION -- DISCUSSION -- 6 Measuring Medical Outcomes: Longitudinal Data on the Differential Impact of Health Care Systems on Chronic Disease -- INTRODUCTION -- INVITED ADDRESS -- INVITED REACTION -- INVITED REACTION -- DISCUSSION.7 Changing Health Care Systems and Access to Care for the Chronically Ill -- INTRODUCTION -- INVITED ADDRESS -- The Chronically Ill: Promises and Risks in An Era of Managed Care and Competitive Markets -- Chronic Illness -- Risk and Current Managed Care Market Dynamics -- Capitation: Moving to the Provider Level? -- Standards of Comparison -- Inadequately Insured Chronically Ill: A Harsher Future -- Vulnerable Populations -- Policy Implications -- INVITED REACTION -- INVITED REACTION -- DISCUSSION -- 8 Training and Utilization of Generalists and Subspecialists at the University of California, Los Angeles -- INTRODUCTION -- INVITED ADDRESS -- Primary Care Physicians -- Subspecialty and Specialty Consultation -- Transportation Systems -- Education Systems -- Graduate Medical Education -- Integrating Subspecialty Medicine Into General Internal Medicine -- Continuing Medical Education -- INVITED REACTION -- INVITED REACTION -- DISCUSSION -- 9 How Easily Do Health Care Systems Adopt New Knowledge, and What Are the Likely Future Developments? -- INTRODUCTION -- INVITED ADDRESS -- INVITED REACTION -- INVITED REACTION -- DISCUSSION -- 10 Issues and Insights Regarding Research, Education, and Training -- INTRODUCTION -- INVITED ADDRESS -- Research -- Education -- Training -- Conclusion -- INVITED REACTION -- DISCUSSION -- 11 Commentary on the Day's Papers -- 12 Conclusions and Recommendations -- CONCLUSION 1 -- CONCLUSION 2 -- CONCLUSION 3 -- CONCLUSION 4 -- CONCLUSION 5 -- CONCLUSION 6 -- CONCLUSION 7 -- CONCLUSION 8 -- CONCLUSION 9 -- A FINAL NOTE -- Appendix A Biographies of Committee Members and Speakers -- Appendix B Workshop Guests.Rheumatoid arthritisUnited StatesSystemic lupus erythematosusUnited StatesManaged care plans (Medical care)United StatesOutcome assessment (Medical care)United StatesChronic diseasesUnited StatesHealth care reformUnited StatesMedical careUnited StatesRheumatoid arthritisSystemic lupus erythematosusManaged care plans (Medical care)Outcome assessment (Medical care)Chronic diseasesHealth care reformMedical care362.1/967227/00973Manning Frederick J1598545Barondess Jeremiah A.1924-101483Institute of Medicine (U.S.).Division of Health Care Services.MiAaPQMiAaPQMiAaPQBOOK9910811525603321Changing health care systems and rheumatic disease4034088UNINA