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Biomedical subjects

R M Lauve

Publications and source records attributed to R M Lauve.

9 recordsLinked to original sources
PubMed1997

What surgeons need to know to help patients receive quality medical care in managed care settings.

BACKGROUND: Americans spend more than $3,300 per person per year on health care, an amount businesses, government, and citizens alike consider too high. MATERIAL REVIEWED: Managed care attempts to offer services at a lower cost, about 10% below that of indemnity insurance, and attempts to controls costs by modifying decisions historically made by physician and patient. Many techniques have been used to modify the decision-making process, with varying effects on quality. CONCLUSIONS: Surgeons can help sustain easily accessible, high-quality care through various personal behaviors and through choosing their managed care partners well.

Accreditation↗
PubMed1995

Severe obesity: expensive to society, frustrating to treat, but important to confront.

Obesity is a major contributor to chronic and costly diseases and disabilities. More than 30% of American adults are obese, and the percentage has been rising for 20 years. A recent estimate placed the direct economic costs of obesity at more than $39.3 billion, or 5.5% of all medical expenditures in the mid-1980s. These numbers underestimate prevalence and cost because the studies designed to monitor our nation's health problems have ignored the most obese segment of the population-individuals weighing more than 350 pounds. The methods used to treat obesity are controversial, some of them lacking appropriate evaluation. Physicians have been reluctant to treat obese people because of the intensity and duration of an effective treatment program. Finally, many treatments fail in the long term and therefore are not considered cost effective. Multiple treatment options are currently available, and this review presents data to aid physicians in selection of the best therapy to help their patients. As cost advantages of comprehensive care of obese patients become more obvious under capitated financing systems, further investigation should focus on mechanisms of choosing more individualized care plans to defined subsegments of the obese population to make care more cost effective.

Health Care Costs↗
PubMed1994

The ethics of health care system reform.

The United States is now engaged in a momentous national debate about health care. How can we provide the best care possible while simultaneously containing cost (to promote the general economic integrity of society) and somehow maintain a semblance of a free health care marketplace. This is not just a political question; it is also a question of ethics. It is an ethical consideration because the current debate is not just about designing or promoting health care systems that can best address our concerns for costs, quality, and accessibility. It appears that at least some participants in the debate would not stop at arguing their beliefs as valid; they would make their beliefs law. Some urge the creation of the right to health care as a matter of law. There are significant differences between beliefs and rights, however, and they need to be considered carefully in the ongoing debate over the future of this country's health care delivery and financing system.

Civil Rights↗
PubMed1993

Hypereosinophylic syndrome in a bronchial asthmatic.

As a poorly understood group of disorders of unknown etiology, the idiopathic hypereosinophylic syndrome (HES) is defined by the common clinical features of prolonged eosinophilia of unknown cause and organ system dysfunction due to the eosinophilia. An allergic asthmatic presented with HES involving the submandibular and sublingual glands and the pleura with effusion. The patient was notable in that these organs have not previously been described as affected by HES, which is described as rare in allergic asthmatics.

Asthma↗
PubMedDate not supplied

Medicare's physician payment reform.

The Omnibus Budget Reconciliation Act (OBRA) of 1989 continues the recent tradition of including far-reaching legislation in what ostensibly is a budget act. The Physician Payment Reform section of OBRA '89 amends Part B of Title XVIII of the Social Security Act by the addition of Section 1848. This article reviews the major substance of the amendment and analyzes the economic effects of the new section on the stakeholders (payers, providers, and consumers).

Fee Schedules↗
PubMedDate not supplied

Medicare's ESRD program, Part 2: Transplantation.

In Part 1 of this discussion (Long, H. "Medicare's ESRD Program, Part 1: Dialysis. "Physician Executive 15(2):24-26, March-April 1989), the focus was on the various forms of dialysis for patients with end stage renal disease (ESRD). In this article, we turn our attention to the alternative therapy-transplantation.

Data Collection↗
PubMedDate not supplied

Toward better care and improved payment.

Current medical-business literature often suggests that the rule for hospitals' economic survival under Medicare's prospective pricing system (PPS) is delivery of minimally acceptable care. Extensive investigation of, or care for, illness not related to the primary cause of admission may erode margins or even generate losses. In at least some diagnostic groupings, however, more rather than less investigation can be not only beneficial to the patient but also fiscally advantageous to the hospital.

Classification↗
PubMedDate not supplied

Emergency departments need aggressive management.

Medicare's prospective pricing system has fostered much cost-consciousness in hospitals regarding inpatient activities. But hospital managers must also examine other activities in search of opportunities to decrease expenses. Managers can minimize the large loss potential in emergency departments by developing detailed protocols and ensuring their consistent application through well-trained employees. This is particularly true for emergency departments having especially acute loss potential because of the volume of care provided to indigents.

Clinical Protocols↗