PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “Health Care Reform”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 19 recordsLinked to original sources
PubMedDate not supplied

The physician's role in health care reform.

Health care in the United States is in crisis. The desire to provide care continually conflicts with the need to contain costs. Historically, physicians have opposed the demand for health care reform, and although many physicians have responded to the current crisis with ambivalence, apathy, or frustration, they have the knowledge, capability, and opportunity to advocate for and to effect reform within the health care delivery system. Many believe that the acknowledgment of costs as a factor in treatment decisions compromises their role as patient advocates, but in the face of increasing government controls and the corporatism of medicine, the human link between physician and patient is even more valuable. The current crisis in health care necessitates cost control. If physicians conscientiously undertake their political, professional, and personal roles, they can reform the health care delivery system in the United States while compassionately advocating for their patients.

Delivery of Health Care↗
PubMed1997

Role of medical education in health care reform.

Health care reform will have great impact on the podiatric physician as the podiatric medical profession continues to integrate into the general medical community. The role of medical education in addressing five major issues that affect health care reform is explored. These issues include specialization, economics, continuous quality improvement, ethics, and fraud.

Economics, Medical↗
PubMed1994

Innovation under federal health care reform.

Health care reform, which seeks to expand coverage and control spending, contains mixed messages for innovators. Policies that advance reform goals are likely to shift resources away from hospitals, specialists, and expensive procedures and toward areas such as prevention and primary care where innovation may yield greater health improvements per dollar spent. The size of these effects depends critically on the extent of cost containment achieved. Constraining spending will be politically difficult because it requires that consumers forego some possible health benefits in return for lower costs. In a climate of cost containment, systematic evaluation of new technology is vital to identify and expand coverage to worthwhile innovations and to assure a fair hearing for innovators.

Cost Control↗
PubMed1994

Understanding the choices in health care reform. The Health Care Study Group.

This commentary is the joint product of a group of concerned scholars, many of them long associated with this journal. It assesses the debate over health care reform with the goal of minimizing the many myths and misunderstandings that exist. We address eight issues most likely to engender confusion: (1) the question whether cost control and universal coverage are contradictory goals, (2) the definition of universal coverage, (3) sources of bureaucracy in a reformed health care system, (4) the meanings of "competition" and "regulation," (5) the difference between short- and long-term measures to control costs, (6) subsidization of universal health care, (7) the role of medical care professionals in decision making about the delivery of services, and (8) the meaning of "choice" for patients and caregivers.

Competitive Medical Plans↗
PubMed1995

Who will provide preventive services? The changing relationships between medical care systems and public health agencies in health care reform.

Health care reform in the United States will likely attempt to expand the health insurance coverage to uninsured groups, control costs, enhance quality, and expand access to care. Preventive services will be assigned to the medical care system, while new roles and responsibilities will be defined for public health agencies. The clinical preventive services likely required are examined in a population of 44,565 persons residing in Otsego County, New York. Expansion of preventive services to Medicaid requests and the uninsured will require considerable resource expenditure to correct the current deficit in preventive services received by these groups. Moreover, the uninsured and Medicaid recipients have high levels of risk behaviors, identifying a need for health education services effective to that population subgroup. The transfer of responsibilities for clinical preventive services to the medical care system may free up resources for public health agencies to focus on other initiatives such as disease surveillance, health education, and quality assurance. New interrelationships, some cooperative and some adversarial, are likely to emerge, due to a closer working relationship between the medical care system and public health agencies than previously seen in American health care.

Delivery of Health Care↗
PubMed2000

My experience with health care reform.

Health care reform efforts have personal and professional implications as well as consequences. This case study describes the author's experience with suddenly losing his chaplaincy position because of budgetary constraints. Methods of coping with the trauma are described.

Budgets↗
PubMed1994

Home care coverage improvements anticipated under health care reform.

Health care reform will affect home care and hospice providers in ways that are as yet unclear. One thing that is certain, however, is that reform will open new doors for providers under both federal and private reimbursement systems. This review of current coverage and existing opportunities gives a background from which providers can look to the future.

Aged↗
PubMed1993

Challenges of leadership in an era of health care reform.

Health care leadership has never been more difficult than in the past decade--and the next ten years promise to be even more demanding. As a new era for health care emerges, organizational leaders will be required to manage increased levels of risk, uncertainty, and rapid change. Successful chief executives will be those who recognize and nurture intangible leadership qualities including knowledge of self, commitment to service, and depth and breadth of vision. With the continued shift away from hospital inpatient care, health care leaders will be called on to develop multipurpose delivery systems that move from a market-based to a community-based focus and deliver high quality services in a cost-effective manner. Several leadership themes will unfold in the midst of health care reform, including: exploiting change for the good of the organization and community; serving as educator, communicator, and comforter to divergent constituencies; and reestablishing a balance between short-term goals and long-term vision.

Chief Executive Officers, Hospital↗
PubMed1994

The neurosurgical intensive care unit in an era of health care reform.

Health care reform, public concern, and managed care will create an environment that demands highly creative strategies to deliver quality care while reducing costs. Patient satisfaction and outcomes will take on a high priority. To meet this challenge, the neurosurgical ICU of the future will be designed with a patient-focused theme wherein the physical environment embodies healing and humanism. Services will be brought to the patient rather than the patient accommodating the system. Patients and families will be the directors of their own care. Staff and families will have access to a highly sophisticated clinical information system, and learning for staff at all levels will be a part of everyday life in the ICU. Unit management will be within a framework of shared governance wherein the power base is with the direct care givers, and decision and policy making happens at the point closest to the patient. Patient outcomes will be a result of a highly organized collaborative model that includes primary nursing, critical paths, and case management. Partnerships between nurses and unit support staff will create skill-mix changes that allow the nurse to spend less time on nonclinical unit maintenance-type functions and more time with the patient and family. This will have a positive fiscal impact as well as enhance patient satisfaction and outcomes.

Cost-Benefit Analysis↗
PubMed1995

Perinatal nurse practitioners and health care reform.

Health care delivery for pregnant women at high risk is changing in response to the nation's need to contain costs and improve care. Perinatal nurse practitioners can provide specialized care to women at high risk in a wide variety of settings. They provide quality, cost-effective care and can improve access to prenatal care for families at risk for untoward pregnancy outcomes.

Curriculum↗
PubMed1994

The economics of health care reform.

Health care costs in the United States have been rising faster than most other goods and services for more than 20 years. The fundamental reason for this rise in cost is unbridled demand for health care services. Demand is high because those who receive the benefits (patients) pay a relatively small portion of the cost of their health insurance. The bulk of health insurance costs are paid by employers or the government for the majority of Americans. To control these rising costs, the demand for health care must be brought under control. This would be best accomplished by a system which requires each individual or family to pay for their own health insurance. This type of payment system would force consumers to become price sensitive and educated on different health insurance plan options. Controlling the demand for health care is the simplest way to control its cost, because in a competitive, consumer-driven market, providers would have to offer cost-effective health care. With this type of market-driven system, appropriate price and utilization levels for health care would be reached within the context of future economic growth and living standards.

Fees, Medical↗
PubMed1996

The informatics of health care reform.

Health care in the United States has entered a period of economic upheaval. Episodic, fee-for-service care financed by indemnity insurance is being replaced by managed care financed by fixed-price, capitated health plans. The resulting focus on reducing costs, especially in areas where there is competition fueled by oversupply of health services providers and facilities, poses new threats to the livelihood of medical libraries and medical librarians but also offers new opportunities. Internet services, consumer health education, and health services research will grow in importance, and organizational mergers will provide librarians with opportunities to assume new roles within their organizations.

Advertising↗
PubMed1994

National health care reform minus public health: a formula for failure.

Universal access to medical services will not address all important health needs. Impending health care reform, guided by public health strategies, could achieve many previously unattainable health goals. However, such a public health role seems unlikely. Public health reaches beyond the current popular notion of prevention focused on individual lifestyle, yet attention to public health authority has waned. The history of immunization, a personal health service effective only within a public health strategy, illustrates the dilemma. Britain required 40 years of National Health Service before it invoked a public health strategy to assure effective immunization. Reformed health care must perform certain functions systematically that in the past were optional for medical practitioners or left to health departments by default. Reformers must rebuild public health authority in states, to assure that medical services we will pay for under health care reform accomplish functions critical to the health of the public.

Health Care Reform↗
PubMedDate not supplied

Analyzing the evidence on European health care reforms.

Health system reform, in Europe as elsewhere, has often been influenced as much by theory and conjecture as by fact and experience. In a study published in September 1997, the Regional Office for Europe of the World Health Organization (WHO) drew together the available evidence about the health care systems in the fifty-one countries of the European region. This paper focuses on western European countries. It reviews a variety of policy strategies and then explores implications from this European experience for the formulation of U.S. health care policy.

Cost Sharing↗