Permanent presence of managed care and outcome of critically ill infants.
In the era of managed care, the potential for high-risk patients of all ages to receive less than optimal care exists because the mechanism for reimbursement is designed to promote savings. The specific ways managed care payment mechanisms actually differ from indemnity insurance or fee-for-service are conceptually quite simple. This article reviews mechanisms such as utilization review, setting length-of-stay bench marks, preapproval for referrals to specialists, specific treatments, procedures, and hospital days.
Schwartz
R M
RM
National Perinatal Information Center, Providence, RI, USA.
Kellogg
R J
RJ
Scanlon
J W
JW
Zhao
Q
Q
D016638:Critical Illness / Q000191:economics / Q000628:therapy; D005260:Female; D005431:Florida; D006279:Health Maintenance Organizations / Q000191:economics / Q000592:standards*; D017052:Hospital Mortality; D006801:Humans; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal / Q000191:economics / Q000592:standards*; D015931:Intensive Care, Neonatal / Q000191:economics / Q000592:standards*; D008297:Male; D008484:Medicaid / Q000191:economics / Q000592:standards*; D016017:Odds Ratio; D011663:Pulmonary Surfactants / Q000627:therapeutic use*; D011787:Quality of Health Care; D044469:Racial Groups; D014481:United States
D011663:Pulmonary Surfactants