Zugl.: Bayreuth, Univ., Diss., 2006

This diploma paper deals with the managed care in the world and in The Czech Republic. It focuses on forms of the managed care, weaker forms of this kind of financing health care - PPOs, POS, on accomplishments and negatives and it's compared with the other kind of financing. The situation is described in all insurence companies in Czech Republic especially in Česká průmyslová pojišťovna.

This dissertation is composed of two essays that examine the role of public and private health insurance on healthcare access, use, and cost containment. In Chapter 1, Dugan, Virani, and Ho examine the impact of Medicare eligibility on healthcare utilization and access. Although Medicare eligibility has been shown to generally increase health care utilization, few studies have examined these relationships among the chronically ill. We use a regression-discontinuity framework to compare physician utilization and financial access to care among people before and after the Medicare eligibility threshold at age 65. Specifically, we focus on coronary heart disease and stroke (CHDS) patients. We find that Medicare eligibility improves health care access and physician utilization for many adults with CHDS, but it may not promote appropriate levels of physician use among blacks with CHDS. My second chapter examines the extent to which the managed care backlash affected managed care's ability to contain hospital costs among short-term, non-federal hospitals between 1998 and 2008. My analysis focuses on health maintenance organizations (HMOs), the most aggressive managed care model. Unlike previous studies that use cross-sectional or fixed effects estimators to address the endogeneity of HMO penetration with respect to hospital costs, this study uses a fixed effects instrumental variable approach. The results suggest two conclusions. First, I find the impact of increased HMO penetration on costs declined over the study period, suggesting regulation adversely impacted managed care's ability to contain hospital costs. Second, when costs are decomposed into unit costs by hospital service, I find the impact of increased HMO penetration on inpatient costs reversed over the study period, but HMOs were still effective at containing outpatient costs.

Thesis (Ph. D.)--Florida State University, 2003. / Advisor: Dr. Wendy P. Crook, Florida State University, School of Social Work. Title and description from dissertation home page (viewed Oct. 6, 2003). Includes bibliographical references.

Thesis (M.S.)--University of Michigan, 1995.

Thesis (Ph. D.)--University of Hong Kong, 1999. / Includes bibliographical references (leaves 204-215).

Thesis (M.S.)--University of Michigan, 1995.

Univ., Diss.--Karlsruhe, 2002.

(MEdPsych)--University of Stellenbosch, 2004. / ENGLISH ABSTRACT: Stories let the world go round! In this study I try to tell a story, to weave the voices from the inside with those from the outside. It's my story, Lize's story, our story and the story of us all, our culture and our society - little patches of that. I try to explain narrative speech - inquiry, curiosity, purpose, inspiration and my commitment to the study. I explore stories about Down Syndrome and inclusive education. I try to follow the path of my own experience in the landscapes of narrative philosophy, inquiry and therapy. I tel! the story of my and Lize's shared experience during our work in therapy, I reflect on the process of this study as a self-story and the therapeutic outcome(s), the opening of more choices and possibilities and beyond: A journey. / AFRIKAANSE OPSOMMING: Stories laat die wêreld draai! In hierdie studie probeer ek 'n storie vertel, weef ek die binnestemme met die buitestemme saam. Dit is my storie, Lize se storie, ons storie saam, ons almal se storie en die storie van ons kultuur en samelewing of liewer kolletjies daarvan. Ek poog om narratiewe navorsing - ondersoek, belangstelling, doel, inspirasie en my verbintenis daartoe te verduidelik. Ek verken stories oor Downsindroom en inklusiewe onderwys. Ek volg die pad van my eie ervaring in die landskap van narratiewe ondersoek, uitgangspunte en terapie. Ek vertelook fragmente van my en Lize se gedeelde ervaring tydens ons saamwees in terapie. Ek reflekteer op die proses van die studie as selfstorie en die terapeutiese uitkoms(te)/ontdekking van meer keuses, moontlikhede en verder: 'n Pelgrimstog.

OBJECTIVE: To investigate the relationship between Medicare Managed Care (MMC) penetration and percentage of disability in older adults (individuals age 65 and older). Considering disability as an indicator of one or more unsuccessfully managed chronic diseases, this study investigates the assumption that managed care improves coordination of care, as well as access to preventive care. If managed care’s mandate is being met, then it should be evidenced in decreased prevalence of older adult disability. METHOD: Taking an ecological approach, this study used data from the Agency for Healthcare Research and Quality (AHRQ, 2003) to compare the percentage of older adult disability in counties from 30 states and the District of Columbia with high and low MMC penetration. Covariates representing various aspects of community context were introduced into a final multivariate linear regression to examine whether MMC penetration was a significant predictor of countywide percent of older adult disability. RESULTS: While MMC penetration was a significant predictor of prevalence of older adult disability in a bivariate analysis (r=-0.197, p < .001), it lost its significance in the final multivariate model. CONCLUSION: While this study does not demonstrate a relationship between MMC penetration and prevalence of older adult disability, it is possible that MMC, once fully implemented under the 2003 Medicare Prescription Drug, Improvement, and Modernization Act, could lead to reduced prevalence of disability.