LEADER 06064nam 2200757 a 450 001 9910811525603321 005 20240416235052.0 010 $a0-309-17507-0 010 $a1-280-19177-5 010 $a9786610191772 010 $a0-309-59674-2 010 $a0-585-08538-2 035 $a(CKB)110986584751958 035 $a(OCoLC)43475712 035 $a(CaPaEBR)ebrary10057000 035 $a(SSID)ssj0000119841 035 $a(PQKBManifestationID)11143398 035 $a(PQKBTitleCode)TC0000119841 035 $a(PQKBWorkID)10073925 035 $a(PQKB)10848717 035 $a(MiAaPQ)EBC3376723 035 $a(Au-PeEL)EBL3376723 035 $a(CaPaEBR)ebr10057000 035 $a(CaONFJC)MIL19177 035 $a(OCoLC)923265664 035 $a(EXLCZ)99110986584751958 100 $a19970117d1996 uy 0 101 0 $aeng 135 $aurcn||||||||| 181 $ctxt 182 $cc 183 $acr 200 10$aChanging health care systems and rheumatic disease /$fCommittee on Changing Health Care Systems and Rheumatic Disease, Division of Health Care Services, Institute of Medicine, Frederick J. Manning and Jeremiah A. Barondess, editors 205 $a1st ed. 210 $aWashington, D.C. $cNational Academy Press$d1996 215 $a1 online resource (252 p.) 300 $aBibliographic Level Mode of Issuance: Monograph 311 $a0-309-05683-7 320 $aIncludes bibliographical references. 327 $aChanging 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. 327 $a7 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. 606 $aRheumatoid arthritis$zUnited States 606 $aSystemic lupus erythematosus$zUnited States 606 $aManaged care plans (Medical care)$zUnited States 606 $aOutcome assessment (Medical care)$zUnited States 606 $aChronic diseases$zUnited States 606 $aHealth care reform$zUnited States 606 $aMedical care$zUnited States 615 0$aRheumatoid arthritis 615 0$aSystemic lupus erythematosus 615 0$aManaged care plans (Medical care) 615 0$aOutcome assessment (Medical care) 615 0$aChronic diseases 615 0$aHealth care reform 615 0$aMedical care 676 $a362.1/967227/00973 701 $aManning$b Frederick J$01598545 701 $aBarondess$b Jeremiah A.$f1924-$0101483 712 02$aInstitute of Medicine (U.S.).$bDivision of Health Care Services. 801 0$bMiAaPQ 801 1$bMiAaPQ 801 2$bMiAaPQ 906 $aBOOK 912 $a9910811525603321 996 $aChanging health care systems and rheumatic disease$94034088 997 $aUNINA