PubMed Health⌕ Search
Home/Archive/PubMed

PubMed · 6471083

Lessons for teaching cost containment.

S J McPhee·S A Chapman·L P Myers·S A Schroeder·J K Leong
View original source ↗Export metadata ↓

Abstract

Increasing financial restrictions on hospitals by the federal government and changing physician reimbursement procedures make it more important to control the use of medical care resources by physicians. A prospective controlled study was made of an educational program for the medical and surgical house staffs and for medical students designed to reduce unneeded orders for low cost, high volume ancillary and nursing services. The program was comprised of six mutually reinforcing components: lectures, medical record audits and reviews, group feedback in the form of cost summaries containing information on unnecessary ordering, hospital price booklets, current patient bills, and pertinent journal articles. Operating at a time of retrospective hospital cost reimbursement, the program achieved only modest reductions in the residents' and students' use of hospital services and no substantive effect upon hospital costs. However, the program participants accepted the program enthusiastically. Several factors crucial to such educational cost containment programs were identified. The authors believe that experience with the program has valuable lessons for other hospitals initiating cost-control efforts.

Explore related subjects

CaliforniaCost ControlHospitalizationHumansInsurance, Health, ReimbursementInternship and ResidencyMedical AuditMedical Staff, HospitalStudents, MedicalTeachingJournal ArticleResearch Support, Non-U.S. Gov't

Keep this discovery

Explore connections, maps & timelines

BibTeXRIS

S J McPhee, S A Chapman, L P Myers, S A Schroeder, J K Leong. 1984. Lessons for teaching cost containment.. https://doi.org/10.1097/00001888-198409000-00005

Cite the original work for its findings. Save a collection to share your selection of sources.

KEEP EXPLORING

Related citations

PubMed2026

Coding-complete genome sequence of grapevine leafroll-associated virus 13 from grapevine in California.

In this study, we report the coding-complete genome sequence of Grapevine leafroll-associated virus 13 (GLRaV-13), isolate CA8881, detected in Vitis vinifera in California, USA. The genome sequence exhibited over 95% nucleotide identity with previously reported GLRaV-13 isolates and contributed to better understanding of the genetic diversity of ampeloviruses infecting grapevine.

California↗
PubMed2007

Increasing syringe access and HIV prevention in California: findings from a survey of local health jurisdiction key personnel.

This article presents results from the first survey of California local health jurisdictions (LHJs) subsequent to passage of legislation that allows for over-the-counter pharmacy sales of syringes. In 2004 Governor Arnold Schwarzenegger signed Senate Bill 1159 (SB1159) into law to "prevent the spread of HIV, hepatitis and other blood-borne disease among drug users, their sexual partners and their children." This legislation permits counties and cities to authorize a local disease prevention demonstration project (DPDP). Once authorized, a DPDP permits individuals to legally purchase and possess up to ten syringes from registered pharmacies without a doctor's prescription. From June to August 2005, we surveyed health departments in all 61 LHJs to assess implementation status of SB1159. Fifty-seven (93%) LHJs responded. Nine (16%) had approved a DPDP by August 2005, 17 (30%) were in the process of obtaining authorization, and 18 (32%) anticipated that SB1159 would never be authorized in their LHJ. Among LHJs that do not plan to approve a DPDP (n = 18), the reasons included: strong community opposition (41%), competing priorities (35%), law enforcement opposition (29%), and little or no interest among pharmacies (29%). In LHJs that have authorized a DPDP, 31.4% of pharmacies registered to legally sell nonprescription syringes. Preliminary results indicate that local coalitions, comprised of public health, waste management and pharmacy officials, have been instrumental in facilitating DPDP authorization. Further research is needed to identify facilitators and barriers to adopting SB1159, to identify areas for improving technical assistance to implementers, and to assess the public health impact of the legislation.

California↗
PubMed2007

Acción Mutua (Shared Action): a multipronged approach to delivering capacity-building assistance to agencies serving Latino communities in the United States.

Culturally appropriate, theory-based capacity-building assistance can serve a vital role in helping HIV prevention providers remain up-to-date, effective, and responsive to those they serve. Funded by the Centers for Disease Control and Prevention (CDC), AIDS Project Los Angeles, in collaboration with San Francisco State University's César E. Chávez Institute, conducted full-day site visits and qualitative interviews in 2005 with mid-level management staff of CDC-funded community-based organizations delivering HIV prevention services to Latino communities in the western region of the United States. We found that agencies we visited (1) had not yet adapted the evidence-based interventions they were using at the time of our visit and (2) requested technical assistance and training in the areas of program development, evaluation, group facilitation techniques, consumer recruitment, client retention, intervention adaptation, and materials development. Findings from this needs assessment were used to inform our seven-pronged approach to delivering capacity-building assistance entitled "Acción Mutua" (Shared Action). The approach emphasizes strategic partnerships, stakeholder involvement, organizational self-assessment, culturally appropriate materials development, interactive training, tailored onsite technical assistance, and professional networking opportunities. This article describes our approach in detail, the assessment process we used to develop it, and its implications for capacity-building practice.

California↗