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Biomedical subjects

A E Barnett

Publications and source records attributed to A E Barnett.

11 recordsLinked to original sources
PubMed1995

The ascendancy of primary care: permanent or temporary?

The conventional wisdom strongly suggests a health care provider food chain for the future: Primary care physicians (PCPs), principally family practitioners, on the top playing the lead role, distantly followed by specialists, with hospitals and other ancillary services even further down the line. Is this a reasonable expectation? Will PCPs dominate the new systems? Or will they be but one of many equally necessary components of these developing integrated health care delivery organizations? Looking at the various models now developing, it would seem that future integrated delivery systems will utilize both PCPs and specialists, but with strong augmentation from a diverse assortment of other health care professionals, including nonphysician providers, educators, and administrators. To separate the illusion of primary care dominance of the coming health care system from the likely reality, we should first determine what is driving the apparent present demand for primary care physicians. Next, we will examine the possible and probable reactions to that demand from an economic standpoint and from the points of view of both health care professionals and the public. Finally, we must try to picture how health care provider organizations of the future are likely to look and how they will integrate their health care professionals.

Cost-Benefit Analysis↗
PubMed1993

HMO performance assessment: group practice strategies and considerations.

Provider evaluation of HMO contracts is a complicated process. The issues are best examined by separating the process into financial, administrative, marketing, and provider relationship areas. Team negotiating by the provider group is a tactic that is effective in dealing with complex risk factors, reinsurance, pharmacy, pools, carve-outs, and nonfinancial enhancements.

Contract Services↗
PubMed1985

Ambient sulfate aerosol deposition in man: modeling the influence of hygroscopicity.

Atmospheric sulfate aerosols [H2SO4, (NH4)2SO4, and NH4HSO4] are of international concern because of their global prevalence and potential irritant or toxic effects on humans. To assess hazards following inhalation exposure, the total dose delivered to the human respiratory tract and its regional distribution must be determined. The mass median aerodynamic diameter of the inhaled aerosol will influence the sites of deposition in the respiratory tract. Atmospheric sulfate aerosols are hygroscopic and will have changing particle sizes and densities as they absorb water vapor in the humid environment of the human respiratory tract. Experimental and theoretical data that describe particle size as a function of temperature and relative humidity were used in computer subroutines of an aerosol deposition model in order to calculate the dose dispersion of H2SO4, (NH4)2SO4, and NH4HSO4 aerosols in man. Different temperature and relative humidity environments that approximately correspond to nasal and oral breathing were studied. The predicted deposition patterns are very different from those of nonhygroscopic aerosols with identical inhaled mass median aerodynamic diameter values.

Aerosols↗
PubMedDate not supplied

The integration of health care as a model for the future.

Ten years ago, health care was characterized as a three-legged stool, each leg representing hospitals, physicians and insurance, respectively. That view is no longer correct, according to Albert Barnett, M.D., who foresees a new, integrated system and what it means for the future of health care.

Ambulatory Care↗
PubMedDate not supplied

A new role for ambulatory care: managing the system.

Buffeted for many years by the winds of financial pressures, the American health care system is in severe disarray. The major components of this system are expending resources on maintaining their traditional roles in order to serve a public that cannot afford all of them. These elements, namely the hospital industry, the insurance industry, and physicians, are trying to achieve a measure of profitability in a system that seems to have little profit to yield. Perhaps the time has arrived for a restructuring of the basic system in order to reward quality and efficient management rather than to perpetuate systems becoming increasingly irrelevant.

Ambulatory Care↗
PubMedDate not supplied

Building a vertical provider system.

There is probably no geographic area in the United States in which the health care environment is more turbulent than that of Southern California. Long before President Clinton's proposals began serious national debate on health care reform, a massive provider-driven realignment of the system was occurring in that region of the country. Multispecialty medical groups have generally led the way and have acquired ever larger managed care populations through merger and acquisition of other groups and practices. Hospitals, hampered by large fixed capital bases, have struggled to reinvent themselves as cost-effective and primary care-friendly environments in order to be attractive to managed care physicians. Almost ignored in this reconfiguration has been the university teaching hospital. This article discusses one attempt to reconcile contractually an integrated, capitated, and managed care-oriented health care system with an academic medical center in a strategic alliance.

Academic Medical Centers↗
PubMedDate not supplied

Public physician practice management companies. Present issues and recommendations for future viability.

For years, physician practices have been perceived as a "cottage industry". Like the old fashioned grocery stores, the opinion of some was that they were ripe for incorporation into organizations which could take advantage of economies of scale and other synergies. Today, many physicians and organizations are beginning to rethink their approach to physician practice management companies (PPMCs). Is it a viable long term strategy for physicians? Does it promote optimal patient care? Can investor-owned companies realistically respond to the health care needs of patients while meeting the financial demands of investors? This article seeks to explore these issues, to examine the current nature of the physician practice management industry, and discuss what PPMCs might do to add value to the practices they manage.

Contract Services↗