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Examining conflicts across organizational boundaries : managed care--provider interactions /Callister, Ronda Roberts. January 1996 (has links)
Thesis (Ph. D.)--University of Missouri-Columbia, 1996. / Typescript. Vita. Includes bibliographical references (leaves 99-105). Also available on the Internet.
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A cross sectional analysis of hospitalizations in the Oklahoma Medcaid adult managed care populationBaker, Daryl Ray. January 2007 (has links) (PDF)
Thesis (D.P.H.)--University of Oklahoma. / Bibliography: leaves 52-53.
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Quality competition and mergers : evidence from the Medicare HMO market /Healy, Deborah A. January 2002 (has links)
Thesis (Ph. D.)--University of Chicago, Dept. of Economics, August 2002 / Includes bibliographical references. Also available on the Internet.
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Adapting the quality function deployment model to health plan designWaterstraat, Frank. Riegle, Rodney P. January 2001 (has links)
Thesis (Ph. D.)--Illinois State University, 2001. / Title from title page screen, viewed March 10, 2006. Dissertation Committee: Rodney P. Riegle (chair), J. Christopher Eisele, George Padavil, John H. Bantham, Thomas J. Bierma. Includes bibliographical references (leaves 124-128) and abstract. Also available in print.
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The collaboration of nurse practitioners and physicians in long-term care using a case-management model in a managed-care environmentKelly-Shelby, Angela Mastracchio. January 2005 (has links)
Thesis (Ed.D.)--University of West Florida, 2005. / Title from title page of source document. Document formatted into pages; contains 208 pages. Includes bibliographical references.
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A critical evaluation of the introduction of managed health care into the South African private health care industryGroenewald, C. A. 10 September 2012 (has links)
M.Comm. / Health care is recognised as a basic human right. The current position of private health care in South Africa is of great concern. Not only is health care almost unaffordable but the future quality of health care also causes great concern. With this in mind it is obvious that alternatives to conventional medical aids and health insurance are necessary to guarantee the continued availability of quality medical care to the South African public. Most people would agree that our private sector health care system is characterised by a depressing history of inadequate planning, control and management. It is for this reason that amendments to the Medical Schemes Act were considered necessary. Certain of these amendments will extend the role played by medical schemes in the management of health care resources. This will result in the traditional boundaries and relationships between the public, health professionals and health care facilities, and the financiers in our private health care system being altered. A new philosophy will evolve based on open and participative practices, as well as increased coordination, integration and cooperation (Veliotes et al, 1993: 12). Internationally, the health care objectives of most countries are to provide access to highquality care for all the people, and to provide this care efficiently and effectively. In the last decade the task of achieving these potentially conflicting objectives has become more difficult. At present, private health care is funded by medical schemes, health insurance companies, employers and individuals themselves. Neither medical aids nor health insurance companies are able to contain the rise in health care cost, which has led to the emergence of a new method of finding, namely Managed Health Care (MHC). Health care cost has accelerated at a rate far above the consumer price index(CPI). Rising health care costs in the private sector have been blamed on structural inefficiencies in the medical aid system. While patients have little incentive to minimise care expenditure, providers have an incentive to overuse the system.
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Perceptions of medical practitioners towards managed healthcareKhosi, Lefume Samuel 05 May 2014 (has links)
M.Com. (Business Management) / The purpose of the present study was to investigate the perceptions of medical practitioners towards managed health care and its implications for patient care. The study population was the medical practitioners in the northern suburbs of Johannesburg. A questionnaire was distributed to 224 medical practitioners in the northern suburbs of Johannesburg. The total number of the respondents was 81 with 53% being general practitioners and 47% being specialists. The findings of the study indicated that the majority of respondents perceived managed healthcare to have a negative impact on doctor-patient relationship, the ability to carry out their ethical obligations towards the patients, and that the limitations implemented by managed health care have a negative impact on the quality of care. The respondents also perceived managed healthcare to be consistent in reducing unnecessary procedures and reducing the expenditure. Recommendations made to remedy the situation include introducing a topic of managed health care as part of undergraduate studies to empower practitioners before they start a private practice. It would be advisable to include medical practitioners to help reform the strategies that will enable medical practitioners to carry out their ethical obligations towards the patients and to deliver quality care to the patients. The study concluded that medical practitioners hold negative perceptions towards managed health care and perceive managed health care to impact the quality of care negatively.
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Digital media as communication tools for health promotion in managed health careBornman, Magda 13 July 2006 (has links)
Please read the abstract in the section 00front of this document / Dissertation (MA (Publishing))--University of Pretoria, 2007. / Information Science / unrestricted
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A Time Study of Audiological Practice Patterns and the Impact of Reimbursement Changes from Third Part PayersTucker, Melody A 13 April 2001 (has links)
The primary objective of the project was to survey audiologists in clinical practice setting to determine the amount of time taken to perform various audiologic tests using Current Procedural Terminology, (CPT) codes to define these tests and if these CPT codes were felt to be adequate. Audiologists were also asked to respond regarding possible impact and reimbursement changes in their clinical practices related to managed care. Responses of audiologists were analyzed to determine: a) adequacy of CPT codes; b)average time to perform various audiologic tests; c) impact managed care onclinical practice; and d) changes in reimbursement as a result of managed care.
The survey was designed to determine the type of work setting, typical job duty, average monthly caseload and hours per day spent on patient care for each respondent. The survey with a cover letter explaining the purpose was mailed to 93 audiologists in clinical setting in the state of Florida. Five were returned undeliverable, and 39 of the remaining 88 were returned either completed or partially completed.
The survey results revealed over 71% of the audiologists felt the current CPT codes were adequate. Time spent performing traditional audiologic tests, such as comprehensive audiometric evaluations and impedance testing, was fairly consistent. Greater time variability occurred in tests used to determine vestibular function. Over three-quarters of the respondents believed managed care has had a negative impact on their clinical practices, while 11% believe they have been positively impacted. Approximately 82% of the audiologists have had reductions in reimbursement as a result of managed care, while 10% have seen no change and 5% have enjoyed slightly greater reimbursement.
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Factors related to the provision of quality health care services at selected public clinics in the rural areas of the Capricorn District, Limpopo ProvinceMatlala, Nick Tlou January 2019 (has links)
Thesis (M.A. (Nursing Science)) -- University of Limpopo, 2019 / Quality health care includes availability, accessibility, affordability, acceptability, competence of health care providers, reducing waiting time, ensuring privacy and confidentiality, ensuring safety and security, and reducing mortality and morbidity. Despite many initiatives made by the National Department of Health through the Minister of Health, provision of quality health care services remains a serious challenge in South Africa, especially in the public rural clinics. Communities from rural areas face many challenges at the public healthcare clinics such as poor infrastructure, attitudes from staff, old equipment, insufficient medicines, dirty healthcare sectors, and longer waiting times, which has led to provision of poor health care services.
Methodology
A quantitative research approach was used to conduct this study. The study was conducted in the Capricorn District of the Limpopo Province. Three municipalities; namely Blouberg, Lepelle-Nkumpi and Aganang, were selected from the five municipalities located in the Capricorn District because they are predominantly rural. A simple random sampling applying fish bowl method was used to select the public clinics in each municipality. A cross-sectional study design was used to conduct the study. Only professional nurses were selected to participate in this study. Data were collected using a structured self-administered questionnaire, over a period of three months. A total of 155 professional nurses were selected because they met the selection criteria. The response rate was 100% because all the 155 questionnaires distributed were completed. Data were analysed using the Statistical Package for Social Sciences program version 22.0 with the assistance of the University of Limpopo statistician.
Results
The findings of the study indicated that only 3 (2%) of the clinics operated for 24 hours, 72 (46%) operated for 8 hours and 80 (52%) operated for 12 hours. The majority of the professional nurses 123 (83%) said that the clinics are overwhelmed by large numbers of patients, whereas 26 (17%) of the professional nurses said that the clinics are not overwhelmed by large numbers of patients. Very few 29 (19%) professional nurses were satisfied with the salary they were paid, whereas the majority 124 (80%) were not satisfied with salary they were paid, and only 2 (1%) were unsure.
Recommendations Recommendations were made to improve the quality of healthcare services in the public rural clinics: The Department of Health should review the salaries they pay professional nurses in rural clinics, particularly the Occupational Specific Dispensation, and they should be given a higher salary. Furthermore, the government should increase the salaries of nurses working in the public rural clinics to at least 10% higher than those in urban clinics within the next 5 years to attract more nurses to the public rural clinics. The Limpopo Provincial Department of Health should liaise with the treasury department to provide realistic budget to accommodate the population. Conclusion
The findings of this study revealed the factors related to the provision of quality health care services at the selected public clinics in the rural areas of the Capricorn District, Limpopo Province. The study was limited to public clinics in the rural areas; therefore, the findings of this study cannot be generalised to the clinics that did not participate in the study.
Keywords: Quality, healthcare services, public rural clinics.
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