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D A Kindig

Publications and source records attributed to D A Kindig.

60 records · Page 4Linked to original sources
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Altering specialty balances.

In an on again, off again pattern, the numbers and distribution of physicians have been of policy concern since the passage of Medicare and Medicaid in the '60s. After a hiatus in the '80s, these issues are a significant part of the current health reform agenda, appearing in one form or another in many of the proposals already offered. If the solutions found this time are to have lasting effects, however, it is critical that the issues are carefully shaped and that those making policy are certain that agreement has been achieved on the basic terms that characterize the issues. This column is jointly edited by Keven M. Fickenscher, MD, Chair, and David A. Kindig, of the College's Forum on National Health Policy.

Health Care Reform↗
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How much administration is today's physician doing?

The substantial changes in the organization and financing of health care services that have occurred in the United States over the past decade have helped to facilitate a growing role for physicians in health care management. These administrative roles for physicians are becoming increasingly important within many health care institutions with regard to such issues as cost containment and cost effectiveness, quality assurance and professional standards, and access to care. The growing complexity and diversity of the delivery system have created the need for more physicians to become involved in "orchestrat(ing)" the management of the medical-industrial complex."

Age Factors↗
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Managing population health.

As experience with managing the health of populations is gained, resources will have to be set aside for rewarding improvements in Health Adjusted Life Expectancy (HALE). Financial incentives and rewards will need to be aligned with improved outcomes, instead of the traditional fee-for-service structure. This article describes how a uniform health outcomes measurement such as HALE could be incorporated by public and private purchasers of medical care and those responsible for the nonmedical determinants of health sectors and services. Three phases of potential development and implementation are outlined: (1) Phase One (1997-2000): Debate, acceptance, and, research; (2) Phase Two (2001-2010): Outcome-based payment for integrated health delivery systems; and (3) Phase Three (2011-2020): incorporating the non-medical determinants and sector.

Community Health Planning↗
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How do you define the health of populations?

What are the perceptions of population health, and how do you define it to move forward on any common action agenda of policy, management, teaching, or research? The author asks a series of questions to clarify the ambiguities around the population health concept, beginning with defining "health" as more than the absence of disease, but less than the breadth of complete well-being. Such a framework requires an operational measure of population health outcome that goes beyond quantity of life (mortality) to add extra dimensions. In other words, the goal is not only to purchase life years, but life years at some level of quality. The article provides an argument for the importance of some aggregate measure of health outcome, such as Health Adjusted Life Expectancy (HALE), as a management tool for purchasing populations health.

Persons with Disabilities↗