Promises and perils of managed care for older patients with cardiac disease.
Managed care for elderly patients with cardiovascular disease will likely become more widespread because it has the propensity to provide comprehensive care while controlling costs. The issues of comorbidity and the changes of aging per se become increasingly important with increasing age and emphasize the need to use the basic principles of clinical decision making in the management of elderly patients, rather than focusing exclusively on a specific acute problem. Currently, there is great turmoil in the managed care market for the elderly with multiple models being tried with highly variable degrees of success from both the financial and patient satisfaction perspective. Physician leadership can be a critical element in resolving many of the dilemmas.
Friesinger
G C
GC
Division of Cardiology, School of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.
Francis
J
J
D000368:Aged; D003363:Cost Control; D006279:Health Maintenance Organizations / Q000191:economics; D006299:Health Services for the Aged / Q000191:economics / Q000592:standards; D006331:Heart Diseases / Q000191:economics* / Q000453:epidemiology / Q000628:therapy*; D006801:Humans; D008329:Managed Care Programs / Q000191:economics / Q000592:standards; D006278:Medicare / Q000191:economics; D017060:Patient Satisfaction; D014481:United States / Q000453:epidemiology